Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex

Autor: Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, Valverde-Roig MJ, Nolasco A, Pérez-Riquelme F, de la Vega M, Portillo I, Salas D
Rok vydání: 2021
Zdroj: PLoS One
r-FISABIO. Repositorio Institucional de Producción Científica
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ISSN: 1932-6203
Popis: In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of participants in CRC screening programs with FIT between 2006 and 2012. A total of 545,505 participations were analyzed. Cancers diagnosed outside of the program were identified after a negative test result (IC_test) up until 2014. The Wilcoxon test was used to compare fecal hemoglobin levels. ROC curves were used to identify the optimal cut-off value for each age and sex group. Screening program results were estimated for different cut-off values. The results show that the Hb concentration was higher in colorectal cancer (average = 179.6 mu g/g) vs. false positives (average = 55.2 mu g/g), in IC_test (average = 3.1 mu g/g) vs. true negatives (average = 0 mu g/g), and in men (average = 166.2 mu g/g) vs. women (average = 140.2 mu g/g) with colorectal cancer. The optimal cut-off values for women were 18.3 mu g/g (50-59y) and 14.6 mu g/g (60-69y), and 16.8 mu g/g (50-59y) and 19.9 mu g/g (60-69y) for men. Using different cut-off values for each age and sex group lead to a decrease in the IC_test rate compared to the 20 mu g/g cut-off value (from 0.40 parts per thousand to 0.37 parts per thousand) and an increase in the false positive rate (from 6.45% to 6.99%). Moreover, test sensitivity improved (90.7%), especially in men and women aged 50-59y (89.4%; 90%) and women aged 60-69y (90.2%). In conclusion, the optimal cut-off value varies for different sex and age groups and the use of an optimal cut-off value for each group improves sensitivity and leads to a small decrease in IC_tests, but also to a larger increase in false positives.
Databáze: OpenAIRE
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