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ADRs correlated in colonoscopy-, FIT-based CRC screening programs
Adenoma detection rates in colonoscopy-based and fecal immunochemical testing-based colorectal cancer screening programs appeared positively and significantly correlated, according to a post-hoc analysis of the Spanish COLONPREV study.
“Our study [shows] relevant results that will determine which is the minimum recommended adenoma detection rate in colorectal cancer (CRC) screening programs based on fecal immunochemical tests (FIT),” Joaquín Cubiella, MD, PhD, from the department of gastroenterology, Complexo Hospitalario de Ourense, Spain, told Healio Gastroenterology. “These data are based on a randomized controlled trial comparing CRC screening based on primary colonoscopy and CRC screening based on FIT in the same population and with the same endoscopists performing colonoscopy in both arms.”
Joaquín Cubiella
Cubiella and colleagues evaluated data on colonoscopies performed between June 2009 and June 2011 during the first round of the COLONPREV study. Colonoscopy was performed in 5,722 individuals, 5,059 of which were primary colonoscopies, and 663 of which were performed after a positive FIT result. Then the researchers used multivariable lineal regression analysis to develop a predictive model, which included confounding variables such as age, sex and region.
In the colonoscopy group, the median ADR was 31% (range, 14% to 51%), compared with 55% (range, 21% to 83%) in the FIT group. These ADRs were positively correlated (Pearson’s coefficient, 0.716; 95% CI, 0.378-0.819; P < .001). Moreover, ADRs in the FIT group were independently related to those in the primary colonoscopy group (regression coefficient, 0.71; 95% CI, 0.19-1.22; P = .009). Regression coefficients of potential confounders were 0.09 (95% CI, –0.1 to 0.21; P = .09) for male sex, 0.3 (95% CI, –0.07 to 0.13; P = .05) for ages 60 to 69 vs. 50 to 59, and 0 (95% CI, –0.01 to 0.01; P = .9) for region.
“According to our findings, we determined that a 45% ADR in FIT-based CRC screening programs is equivalent, in terms of quality indicator, to the well-accepted 20% figure in colonoscopy screening,” Cubiella said. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.