Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection
Authors: Umair Masood, Amit Singh Dhamoon, Uma Murthy
Journal: Annals of Internal Medicine (2019)

Letters21 May 2019Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer DetectionUmair Masood, MD, Amit Singh Dhamoon, MD, PhD, and Uma Murthy, MDUmair Masood, MDSUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, New York (U.M., A.S.D., U.M.)Search for more papers by this author, Amit Singh Dhamoon, MD, PhDSUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, New York (U.M., A.S.D., U.M.)Search for more papers by this author, and Uma Murthy, MDSUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, New York (U.M., A.S.D., U.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0094 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Selby and colleagues' study (1) showed how tailoring fecal immunochemical test (FIT) thresholds according to patient demographic characteristics can improve detection rates for colorectal cancer (CRC). The FIT has replaced the guaiac-based fecal occult blood test for CRC screening because it has better sensitivity and specificity. However, being an effective screening test is not enough. Selby and associates (2) previously showed that the low rate of timely receipt of colonoscopy in FIT-positive patients limits the effectiveness of screening. Another impediment to the effectiveness of the FIT that has received little attention is its inordinately high rate of ...References1. Selby K, Jensen CD, Lee JK, Doubeni CA, Schottinger JE, Zhao WK, et al. Influence of varying quantitative fecal immunochemical test positivity thresholds on colorectal cancer detection. A community-based cohort study. Ann Intern Med. 2018;169:439-47. [PMID: 30242328]. doi:10.7326/M18-0244 LinkGoogle Scholar2. Selby K, Baumgartner C, Levin TR, Doubeni CA, Zauber AG, Schottinger J, et al. Interventions to improve follow-up of positive results on fecal blood tests. A systematic review. Ann Intern Med. 2017;167:565-75. [PMID: 29049756]. doi:10.7326/M17-1361 LinkGoogle Scholar3. Pavelock N, Masood U, Sharma A, Gupta A, Murthy U. Fecal immunochemical testing (FIT) for colorectal cancer screening (CRC) in a veteran population: is it being used appropriately? [Abstract]. Presented at American College of Gastroenterology 2016 Annual Scientific Meeting, Las Vegas, Nevada, 16 October 2016. Abstract no. P185. Google Scholar4. U.S. Department of Veterans Affairs. VA lauded by National Colorectal Cancer Roundtable for screening rates [press release]. Washington, DC: U.S. Department of Veterans Affairs; 22 November 2016. Accessed at www.va.gov/opa/pressrel/pressrelease.cfm?id=2835 on 22 September 2018. Google Scholar5. 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: SUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, New York (U.M., A.S.D., U.M.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0094. 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 Kevin Selby , Theodore R. Levin , and Douglas A. Corley Metrics 21 May 2019Volume 170, Issue 10Page: 736KeywordsAdenomasColonoscopyColorectal cancerConflicts of interestDisclosureHematologic testsHemorrhageInflammatory bowel diseasePerformance measuresSpecificity ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...