Rate of Detection of Advanced Neoplasms in Proximal Colon by Simulated Sigmoidoscopy vs Fecal Immunochemical Tests
| Autor: | Antoni Castells, Enrique Quintero, Cristina Álvarez, Luis Bujanda, Joaquín Cubiella, Dolores Salas, Ángel Lanas, Fernando Carballo, Juan Diego Morillas, Cristina Hernández, Rodrigo Jover, Elizabeth Hijona, Isabel Portillo, José M. Enríquez–Navascués, Vicent Hernández, Alfonso Martínez-Turnes, Carlos Menéndez-Villalva, Carmen González-Mao, Teresa Sala, Marta Ponce, Mercedes Andrés, Gloria Teruel, Antonio Peris, Federico Sopeña, Francisca González-Rubio, Agustín Seoane-Urgorri, Jaume Grau, Anna Serradesanferm, Àngels Pozo, Maria Pellisé, Francesc Balaguer, Akiko Ono, José Cruzado, Francisco Pérez-Riquelme, Inmaculada Alonso-Abreu, Marta Carrillo-Palau, Mariola de la Vega-Prieto, Rosario Iglesias, Javier Amador, José Manuel Blanco, Rocio Sastre, Juan Ferrándiz, Ma José González-Hernández, Montserrat Andreu, Xavier Bessa, Angel Lanas, Alberto Moya-Calvo, Mónica Polo-Tomas, null Maria Pilar Roncales, Pilar Sebastian-Martínez, María Ángeles Valencia-Doblas, Nieves Valero-Capilla, María E. Alkiza, Jone Altzibar, Pilar Amiano, Juan Arenas, Edurne Artiñano, Angel Cosme, Isabel Egitegi, Kepa Elorriaga, Jose L. Elósegui, José M. Enriquez-Navascués, Cristina Erce, Inés Gil, María A. Gutiérrez-Stampa, Marta Herreros, Mariluz Jaúregui, Eva Laredo, Roberto Martínez, Maria J. Mitxelena, Isabel Montalvo, Carlos Placer, Cristina Sarasqueta, Onofre Alarcón, María Luisa Díez-Fuentes, Antonio Gimeno-García, Yanira González-Méndez, Manuel Hernández-Guerra, Renata Linertová, David Nicolás-Perez, Juana María Reyes-Melián, Josep M. Augé, Mercè Barau, Felipe Bory, Andrea Burón, Xavier Castells, Mercè Comas, Míriam Cuatrecasas, Maria Estrada, Olga Ferrer, Imma Garrell, Rafael Guayta, María López-Cerón, Francesc Macià, Leticia Moreira, Teresa Ocaña, Mercè Piracés, Sandra Polbach, Marc Puigvehí, Cristina Rodríguez, Maria Sala, Agustín Seoane, Judith Sivilla, Antoni Trilla, Mª Belén Aguado, Susana Aldecoa, Raquel Almazán, Ana Alonso, Inés Castro, Estela Cid, Lucía Cid, Joan Clofent, Mª Luisa de Castro, Pamela Estévez, Ana Belén Fernández, Mª Dolores González, Simoneta González, Mª Carmen González-Mao, Begoña Iglesias, Felipe Iglesias, Pilar Iglesias, Ángeles López-Martínez, Ramiro Macenlle, Alfonso Martínez, David Martínez, Carlos Menéndez, Carmen Méndez, José Antonio Hermo, Isabel Pérez, Carmen Portasany, Mar Rionda, Concepción Rivera, Benito Rodríguez, Rosa Rodríguez, Manuel Rubio, María Isolina Santiago, Miriam Vázquez, José Ángel Vázquez, Pablo Vega, Mª Carmen Vidal, Raquel Zubizarreta |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Colon Colorectal cancer Cost-Benefit Analysis Colonoscopy Gastroenterology Asymptomatic Feces Internal medicine medicine Humans Mass Screening Sigmoidoscopy Aged Splenic flexure Hepatology medicine.diagnostic_test business.industry Odds ratio Middle Aged medicine.disease Immunohistochemistry United Kingdom Confidence interval Relative risk Colonic Neoplasms Female medicine.symptom business |
| Zdroj: | Europe PubMed Central CLINICAL GASTROENTEROLOGY AND HEPATOLOGY r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| ISSN: | 1542-3565 1542-7714 |
| DOI: | 10.1016/j.cgh.2014.03.022 |
| Popis: | BACKGROUND & AIMS: We compared the ability of biennial fecal immunochemical testing (FIT) and one-time sigmoidoscopy to detect colon side-specific advanced neoplasms in a population-based, multicenter, nationwide, randomized controlled trial. METHODS: We identified asymptomatic men and women, 50-69 years old, through community health registries and randomly assigned them to groups that received a single colonoscopy examination or biennial FIT. Sigmoidoscopy yield was simulated from results obtained from the colonoscopy group, according to the criteria proposed in the UK Flexible Sigmoidoscopy Trial for colonoscopy referral. Patients who underwent FIT and were found to have >= 75 ng hemoglobin/mL were referred for colonoscopy. Data were analyzed from 5059 subjects in the colonoscopy group and 10,507 in the FIT group. The main outcome was rate of detection of any advanced neoplasm proximal to the splenic flexure. RESULTS: Advanced neoplasms were detected in 317 subjects (6.3%) in the sigmoidoscopy simulation group compared with 288 (2.7%) in the FIT group (odds ratio for sigmoidoscopy, 2.29; 95% confidence interval, 1.93-2.70; P = .0001). Sigmoidoscopy also detected advanced distal neoplasia in a higher percentage of patients than FIT (odds ratio, 2.61; 95% confidence interval, 2.20-3.10; P = .0001). The methods did not differ significantly in identifying patients with advanced proximal neoplasms (odds ratio, 1.17; 95% confidence interval, 0.78-1.76; P = .44). This was probably due to the lower performance of both strategies in detecting patients with proximal lesions (sigmoidoscopy detected these in 19.1% of patients and FIT in 14.9% of patients) vs distal ones (sigmoidoscopy detected these in 86.8% of patients and FIT in 33.5% of patients). Sigmoidoscopy, but not FIT, detected proximal lesions in lower percentages of women (especially those 50-59 years old) than men. CONCLUSIONS: Sigmoidoscopy and FIT have similar limitations in detecting advanced proximal neoplasms, which depend on patients' characteristics; sigmoidoscopy underperforms for women 50-59 years old. Screening strategies should be designed on the basis of target population to increase effectiveness and cost-effectiveness. ClinicalTrials.govnumber: NCT00906997 |
| Databáze: | OpenAIRE |
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