Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection
Authors: Kevin Selby, Theodore R. Levin, Douglas A. Corley
Journal: Annals of Internal Medicine (2019)

Letters21 May 2019Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer DetectionKevin Selby, MD, MAS, Theodore R. Levin, MD, and Douglas A. Corley, MD, PhDKevin Selby, MD, MASUniversity of Lausanne, Lausanne, Switzerland (K.S.), Theodore R. Levin, MDKaiser Permanente Medical Center, Walnut Creek, California (T.R.L.), and Douglas A. Corley, MD, PhDKaiser Permanente Northern California, Oakland, California (D.A.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0095 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Masood and colleagues raise important questions about quantitative FIT screening. This test presents the dual challenge of requiring both repeated annual screening and adequate follow-up of positive results. Whenever possible, the FIT should be implemented as part of a complete process (organized screening) rather than individual testing without systematic tracking (opportunistic screening) (1). Kaiser Permanente has implemented an organized program that mails FITs annually, contacts FIT-positive patients, and tracks these patients until they receive or decline colonoscopy or the test is contraindicated (2).Dr. Masood and colleagues note that the Syracuse VA Medical Center had high rates ...References1. Tiro JA, Kamineni A, Levin TR, Zheng Y, Schottinger JS, Rutter CM, et al. The colorectal cancer screening process in community settings: a conceptual model for the population-based research optimizing screening through personalized regimens consortium. Cancer Epidemiol Biomarkers Prev. 2014;23:1147-58. [PMID: 24917182] doi:10.1158/1055-9965.EPI-13-1217 CrossrefMedlineGoogle Scholar2. Jensen CD, Corley DA, Quinn VP, Doubeni CA, Zauber AG, Lee JK, et al. Fecal immunochemical test program performance over 4 rounds of annual screening. A retrospective cohort study. Ann Intern Med. 2016;164:456-63. [PMID: 26811150]. doi:10.7326/M15-0983 LinkGoogle Scholar3. Senore C, Basu P, Anttila A, Ponti A, Tomatis M, Vale DB, et al. Performance of colorectal cancer screening in the European Union Member States: data from the second European screening report. Gut. 2018. [PMID: 30530530] doi:10.1136/gutjnl-2018-317293 CrossrefMedlineGoogle Scholar4. Halloran SP. Intelligent use of the fecal immunochemical test in population-based screening. Ann Intern Med. 2018;169:496-7. [PMID: 30242365]. doi:10.7326/M18-2257 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Lausanne, Lausanne, Switzerland (K.S.)Kaiser Permanente Medical Center, Walnut Creek, California (T.R.L.)Kaiser Permanente Northern California, Oakland, California (D.A.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0244. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInfluence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection Kevin Selby , Christopher D. Jensen , Jeffrey K. Lee , Chyke A. Doubeni , Joanne E. Schottinger , Wei K. Zhao , Jessica Chubak , Ethan Halm , Nirupa R. Ghai , Richard Contreras , Celette Skinner , Aruna Kamineni , Theodore R. Levin , and Douglas A. Corley Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection Umair Masood , Amit Singh Dhamoon , and Uma Murthy Metrics Cited byCurrent and future colorectal cancer screening strategies 21 May 2019Volume 170, Issue 10Page: 736-737KeywordsBlood pressureColonoscopyColorectal cancerDecision makingDisclosureElectronic medical recordsRelative risk ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...