The multitarget fecal immunochemical test versus the fecal immunochemical test for programmatic colorectal cancer screening: a cross-sectional intervention study with paired design.

Autor: Wisse PHA; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands.; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Doctor Molewaterplein 40, Rotterdam, GD, 3015, the Netherlands., de Klaver W; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Doctor Molewaterplein 40, Rotterdam, GD, 3015, the Netherlands.; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the Netherlands., van Wifferen F; Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, HV, 1081, the Netherlands., Meiqari L; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands., Bierkens M; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands., Greuter MJE; Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, HV, 1081, the Netherlands., Carvalho B; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands., van Leerdam ME; Department of Gastro-intestinal Oncology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, 1066, the Netherlands., Spaander MCW; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Doctor Molewaterplein 40, Rotterdam, GD, 3015, the Netherlands., Dekker E; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, the Netherlands., Coupé VMH; Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, HV, 1081, the Netherlands., de Wit M; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands. m.d.wit@nki.nl., Meijer GA; Department of Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, the Netherlands.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2022 Dec 12; Vol. 22 (1), pp. 1299. Date of Electronic Publication: 2022 Dec 12.
DOI: 10.1186/s12885-022-10372-2
Abstrakt: Background: Many screening programs for colorectal cancer (CRC) use the fecal immunochemical test (FIT) to triage individuals for colonoscopy. Although these programs reduce CRC incidence and CRC-related mortality, the detection of advanced precursor lesions (advanced adenomas and advanced serrated polyps) by FIT could be improved. As an alternative for FIT, the antibody-based multitargetFIT (mtFIT) has been proposed. The mtFIT measures three protein markers: hemoglobin, calprotectin, and serpin family F member 2. In a retrospective diagnostic accuracy study in a large colonoscopy-controlled series (n = 1284), mtFIT showed increased sensitivity for advanced neoplasia (AN), at equal specificity, compared to FIT (42.9% versus 37.3%; p = 0.025). This increase was mainly due to a higher sensitivity of mtFIT for advanced adenomas (37.8% versus 28.1% for FIT; p = 0.006). The present mtFIT study aims to prospectively validate these findings in the context of the Dutch national CRC screening program.
Method: The mtFIT study is a cross-sectional intervention study with a paired design. Eligible subjects for the Dutch FIT-based national CRC screening program are invited to perform mtFIT in addition to FIT. Samples are collected at home, from the same bowel movement, and are shipped to a central laboratory by postal mail. If either one or both tests are positive, participants are referred for colonoscopy. Detailed colonoscopy and pathology data are centrally stored in a national screening database (ScreenIT; Topicus, Deventer, the Netherlands) that is managed by the screening organization, and will be retrieved for this study. We aim to determine the relative sensitivity for AN, comprising of CRC, advanced adenomas and advanced serrated polyps, of mtFIT compared to FIT at an equal positivity rate. Additionally, we will use the Adenoma and Serrated Pathway to Colorectal CAncer model to predict lifetime health effects and costs for programmatic mtFIT- versus FIT-based screening. The target sample size is 13,131 participants.
Discussion: The outcome of this study will inform on the comparative clinical utility of mtFIT versus FIT in the Dutch national CRC screening program and is an important step forward in the development of a new non-invasive stool test for CRC screening.
Trial Registration: Clinicaltrials.gov ; NCT05314309, registered April 6th 2022, first inclusions March 25th 2022 https://clinicaltrials.gov/ct2/results?cond=&term=NCT05314309&cntry=&state=&city=&dist =.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje