Endoscopy 2015; 47(11): 1011-1017
DOI: 10.1055/s-0034-1392412
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Fecal immunochemical testing results and characteristics of colonic lesions

Sascha C. van Doorn
1   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Inge Stegeman
2   Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
,
An K. Stroobants
3   Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands
,
Marco W. Mundt
4   Department of Gastroenterology and Hepatology, Flevoziekenhuis Almere, The Netherlands
,
Thomas R. de Wijkerslooth
1   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Paul Fockens
1   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Ernst J. Kuipers
5   Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
,
Patrick M. Bossuyt
2   Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
,
Evelien Dekker
1   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

submitted 20 August 2014

accepted after revision 01 April 2015

Publication Date:
30 June 2015 (online)

Background and study aims: Fecal immunochemical tests (FIT) are used to detect blood in feces, which might indicate the presence of colorectal neoplasia. The aim of this study was to investigate whether FIT results vary depending on the characteristics of colonic lesions.

Patients and methods: This was a retrospective analysis of lesions detected in a cohort of asymptomatic individuals (aged 50 – 75 years) who were invited to participate in a FIT-based screening pilot in The Netherlands. The mean FIT result was compared across subgroups of individuals defined by histopathology of the most advanced lesion detected. In addition, the results were compared with data from a primary colonoscopy screening trial, in which participants also completed a FIT.

Results: In three rounds of FIT-based screening, a total of 877 FIT-positive individuals underwent colonoscopy. Higher mean FIT results (hemoglobin [Hb]/g feces) were observed in individuals with carcinomas (199 μg Hb/g) and advanced adenomas (87 μg Hb/g) compared with participants with nonadvanced adenomas (50 μg Hb/g) or those with serrated lesions (46 μg Hb/g) (P < 0.001). In the primary colonoscopy trial, 1256 participants completed a FIT test and underwent colonoscopy. The number of participants with nonadvanced adenomas as the most advanced lesion was comparable between this group and the FIT-based screening group (20 % vs. 22 %).

Conclusion: In FIT-based screening, the mean FIT results varied depending on the characteristics of the most advanced colonic lesion. The proportion of participants with a nonadvanced adenoma as the most advanced lesion was similar in the FIT-based screening group and in the primary colonoscopy screening group, suggesting that these lesions are coincidental findings rather than FIT-detected findings.

Clinical trial registration: www.trialregister.nl number NTR2755.

Fig. e1, e2 and Table e2, e3

 
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