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Optimizing Positivity Thresholds for a Risk-Adapted Screening Strategy in Colorectal Cancer Screening

文献类型：期刊论文

作者Lu, Ming8; Wang, Le1; Zhang, Yuhan8; Liu, Chengcheng6,7; Lu, Bin8; Du, Lingbin1; Liao, Xianzhen5; Dong, Dong4; Wei, Donghua3; Gao, Yi2
刊名CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY
出版日期2021-08-01
卷号12
DOI10.14309/ctg.0000000000000398
通讯作者Chen, Hongda(hongda.chen@cicams.ac.cn) ; Dai, Min(daimin2002@hotmail.com)
英文摘要INTRODUCTION: Risk-adapted screening combining the Asia-Pacific Colorectal Screening score, fecal immunochemical test (FIT), and colonoscopy improved the yield of colorectal cancer screening than FIT. However, the optimal positivity thresholds of risk scoring and FIT of such a strategy warrant further investigation. METHODS: We included 3,407 participants aged 50-74 years undergoing colonoscopy from a colorectal cancer screening trial. For the risk-adapted screening strategy, subjects were referred for subsequent colonoscopy or FIT according to their risk scores. Diagnostic performance was evaluated for FIT and the risk-adapted screening method with various positivity thresholds. Furthermore, a modeled screening cohort was established to compare the yield and cost using colonoscopy, FIT, and the risk-adapted screening method in a single round of screening. RESULTS: Risk-adapted screening method had higher sensitivity for advanced neoplasm (AN) (27.6%-76.3% vs 13.8%-17.3%) but lower specificity (46.6%-90.8% vs 97.4%-98.8%) than FIT did. In a modeled screening cohort, FIT-based screening would be slightly affected because the threshold varied with a reduction of 76.0%-80.9% in AN detection and 82.0%-84.4% in cost when compared with colonoscopy. By contrast, adjusting the threshold of Asia-Pacific Colorectal Screening score from 3 to 5 points for risk-adapted screening varied from an increase of 12.6%-14.1% to a decrease of 55.6%-60.1% in AN detection, with the reduction of cost from 4.2%-5.3% rising to 66.4%-68.5%. DISCUSSION: With an appropriate positivity threshold tailored to clinical practice, the risk-adapted screening could save colonoscopy resources and cost compared with the colonoscopy-only and FIT-only strategies.
WOS关键词FECAL IMMUNOCHEMICAL TEST ; COLONOSCOPY ; TESTS ; NEOPLASIA
资助项目Beijing Nova Program of Science and Technology[Z191100001119065] ; Natural Science Foundation of Beijing Municipality[7202169] ; CAMS Innovation Fund for Medical Sciences[2017-I2M-1-006]
WOS研究方向Gastroenterology & Hepatology
语种英语
WOS记录号WOS:000711670100004
出版者LIPPINCOTT WILLIAMS & WILKINS
资助机构Beijing Nova Program of Science and Technology ; Natural Science Foundation of Beijing Municipality ; CAMS Innovation Fund for Medical Sciences
源URL[http://ir.hfcas.ac.cn:8080/handle/334002/125765]  
专题中国科学院合肥物质科学研究院
通讯作者Chen, Hongda; Dai, Min
作者单位1.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp, Dept Canc Prevent, Hangzhou, Peoples R China
2.Kunming Med Univ, Dept Colorectal Surg, Tumor Hosp Yunnan Prov, Affiliated Hosp 3, Kunming, Yunnan, Peoples R China
3.Anhui Prov Canc Hosp, Dept Canc Prevent, Hefei, Peoples R China
4.Xuzhou Canc Hosp, Off Canc Prevent & Treatment, Xuzhou, Jiangsu, Peoples R China
5.Hunan Canc Hosp, Dept Canc Prevent, Changsha, Peoples R China
6.Zhejiang Univ, Affiliated Hosp 2, Canc Inst, Key Lab Canc Prevent & Intervent,Sch Med, Hangzhou, Peoples R China
7.Zhejiang Univ, Affiliated Hosp 2, Dept Colorectal Surg & Oncol, Key Lab Canc Prevent & Intervent,Sch Med, Hangzhou, Peoples R China
8.Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Clin Res Ctr Canc, Off Canc Screening,Natl Canc Ctr, Beijing, Peoples R China
推荐引用方式
GB/T 7714		 Lu, Ming,Wang, Le,Zhang, Yuhan,et al. Optimizing Positivity Thresholds for a Risk-Adapted Screening Strategy in Colorectal Cancer Screening[J]. CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY,2021,12.
APA Lu, Ming.,Wang, Le.,Zhang, Yuhan.,Liu, Chengcheng.,Lu, Bin.,...&Dai, Min.(2021).Optimizing Positivity Thresholds for a Risk-Adapted Screening Strategy in Colorectal Cancer Screening.CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY,12.
MLA Lu, Ming,et al."Optimizing Positivity Thresholds for a Risk-Adapted Screening Strategy in Colorectal Cancer Screening".CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY 12(2021).

入库方式： OAI收割

来源：合肥物质科学研究院

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