Quality Monitoring of a FIT-Based Colorectal Cancer Screening Program.


Journal

Clinical chemistry
ISSN: 1530-8561
Titre abrégé: Clin Chem
Pays: England
ID NLM: 9421549

Informations de publication

Date de publication:
03 2019
Historique:
received: 28 06 2018
accepted: 21 12 2018
pubmed: 18 1 2019
medline: 31 12 2019
entrez: 18 1 2019
Statut: ppublish

Résumé

Quality assessment is crucial for consistent program performance of colorectal cancer (CRC) screening programs using fecal immunochemical test for hemoglobin (FIT). However, literature on the consistency of FIT performance in laboratory medicine was lacking. This study examined the consistency of FIT in testing positive or detecting advanced neoplasia (AN) for different specimen collection devices, lot reagents, and laboratories. All participants with a FIT sample with a cutoff concentration of 47 μg Hb/g feces in the Dutch CRC screening program in 2014 and 2015 were included in the analyses. Multivariable logistic regression analyses were performed to estimate the odds ratios of collection devices, reagents, and laboratories on testing positive or detecting AN and positive predictive value (PPV). In total, 87519 (6.4%) of the 1371169 participants tested positive. Positivity rates and detection rates of AN differed between collection devices and reagents (all Variations were observed in positivity and detection rates between collection devices and reagents, but there was no detected variation in PPV. Although the overall population effect of these variations on the screened population is expected to be modest, there is room for improvement.

Sections du résumé

BACKGROUND
Quality assessment is crucial for consistent program performance of colorectal cancer (CRC) screening programs using fecal immunochemical test for hemoglobin (FIT). However, literature on the consistency of FIT performance in laboratory medicine was lacking. This study examined the consistency of FIT in testing positive or detecting advanced neoplasia (AN) for different specimen collection devices, lot reagents, and laboratories.
METHODS
All participants with a FIT sample with a cutoff concentration of 47 μg Hb/g feces in the Dutch CRC screening program in 2014 and 2015 were included in the analyses. Multivariable logistic regression analyses were performed to estimate the odds ratios of collection devices, reagents, and laboratories on testing positive or detecting AN and positive predictive value (PPV).
RESULTS
In total, 87519 (6.4%) of the 1371169 participants tested positive. Positivity rates and detection rates of AN differed between collection devices and reagents (all
CONCLUSIONS
Variations were observed in positivity and detection rates between collection devices and reagents, but there was no detected variation in PPV. Although the overall population effect of these variations on the screened population is expected to be modest, there is room for improvement.

Identifiants

pubmed: 30651228
pii: clinchem.2018.294041
doi: 10.1373/clinchem.2018.294041
doi:

Substances chimiques

Hemoglobins 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

419-426

Informations de copyright

© 2018 American Association for Clinical Chemistry.

Auteurs

Esther Toes-Zoutendijk (E)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands; e.toes-zoutendijk@erasmusmc.nl.

Johannes M G Bonfrer (JMG)

Clinical Chemistry, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.

Christian Ramakers (C)

Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Marc Thelen (M)

Clinical Chemistry and Hematology, Amphia Hospital, Breda, the Netherlands.

Manon C W Spaander (MCW)

Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Evelien Dekker (E)

Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.

Miriam P van der Meulen (MP)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Maaike Buskermolen (M)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Anneke J van Vuuren (AJ)

Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Ernst J Kuipers (EJ)

Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Folkert J van Kemenade (FJ)

Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Marie-Louise F van Velthuysen (MF)

Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Maarten G J Thomeer (MGJ)

Radiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Harriët van Veldhuizen (H)

Quality Improvement, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Marjolein van Ballegooijen (M)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Harry J de Koning (HJ)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Monique E van Leerdam (ME)

Gastroenterology and Hepatology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.

Iris Lansdorp-Vogelaar (I)

Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

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Classifications MeSH