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The optimal cut-off value in fit-based colorectal cancer screening: An observational study

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Njor, Sisse Helle ; Andersen, Berit ; Friis-Hansen, Lennart ; de Haas, Niels ; Linnemann, Dorte ; Nørgaard, Henrik ; Roikjaer, Ole ; Søndergaard, Bo ; Rasmussen, Morten. / The optimal cut-off value in fit-based colorectal cancer screening : An observational study. I: Cancer Medicine. 2021 ; Bind 10, Nr. 5. s. 1872-1879.

Bibtex

@article{e7a0ca99f80a412ebbc35859e094c9e5,
title = "The optimal cut-off value in fit-based colorectal cancer screening: An observational study",
abstract = "BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut-off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut-off value is sparse and based on studies with a low number of cancer cases.METHODS: This observational study used data from the Danish Colorectal Cancer Screening Database. Sensitivity and specificity were estimated for various cut-off values based on a large number of cancers. Traditionally optimal cut-off values are found by weighting sensitivity and specificity equally. As this might result in too many unnecessary colonoscopies we also provide optimal cut-off values for different weighting of sensitivity and specificity/number of needed colonoscopies to detect one cancer.RESULTS: Weighting sensitivity and specificity equally gives an optimal cut-off value of 45 ng Hb/ml. This, however, means making 24 colonoscopies to detect one cancer. Weighting sensitivity lower and for example, aiming at making about 16 colonoscopies to detect one cancer, gives an optimal cut-off value of 125 ng Hb/ml.CONCLUSIONS: The optimal cut-off value in an FIT population-based screening program is 45 ng Hb/ml, when as traditionally sensitivity and specificity are weighted equally. If, however, 24 colonoscopies needed to detect one cancer is too huge a burden on the health care system and the participants, 80, 125, 175, and 350 ng Hb/ml are optimal cut-off values when only 19/16/14/10 colonoscopies are accepted to find one cancer.",
keywords = "capacity building, colorectal neoplasms, mass screening, sensitivity, specificity",
author = "Njor, {Sisse Helle} and Berit Andersen and Lennart Friis-Hansen and {de Haas}, Niels and Dorte Linnemann and Henrik N{\o}rgaard and Ole Roikjaer and Bo S{\o}ndergaard and Morten Rasmussen",
note = "{\textcopyright} 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.",
year = "2021",
month = mar,
doi = "10.1002/cam4.3761",
language = "English",
volume = "10",
pages = "1872--1879",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "5",

}

RIS

TY - JOUR

T1 - The optimal cut-off value in fit-based colorectal cancer screening

T2 - An observational study

AU - Njor, Sisse Helle

AU - Andersen, Berit

AU - Friis-Hansen, Lennart

AU - de Haas, Niels

AU - Linnemann, Dorte

AU - Nørgaard, Henrik

AU - Roikjaer, Ole

AU - Søndergaard, Bo

AU - Rasmussen, Morten

N1 - © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

PY - 2021/3

Y1 - 2021/3

N2 - BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut-off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut-off value is sparse and based on studies with a low number of cancer cases.METHODS: This observational study used data from the Danish Colorectal Cancer Screening Database. Sensitivity and specificity were estimated for various cut-off values based on a large number of cancers. Traditionally optimal cut-off values are found by weighting sensitivity and specificity equally. As this might result in too many unnecessary colonoscopies we also provide optimal cut-off values for different weighting of sensitivity and specificity/number of needed colonoscopies to detect one cancer.RESULTS: Weighting sensitivity and specificity equally gives an optimal cut-off value of 45 ng Hb/ml. This, however, means making 24 colonoscopies to detect one cancer. Weighting sensitivity lower and for example, aiming at making about 16 colonoscopies to detect one cancer, gives an optimal cut-off value of 125 ng Hb/ml.CONCLUSIONS: The optimal cut-off value in an FIT population-based screening program is 45 ng Hb/ml, when as traditionally sensitivity and specificity are weighted equally. If, however, 24 colonoscopies needed to detect one cancer is too huge a burden on the health care system and the participants, 80, 125, 175, and 350 ng Hb/ml are optimal cut-off values when only 19/16/14/10 colonoscopies are accepted to find one cancer.

AB - BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut-off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut-off value is sparse and based on studies with a low number of cancer cases.METHODS: This observational study used data from the Danish Colorectal Cancer Screening Database. Sensitivity and specificity were estimated for various cut-off values based on a large number of cancers. Traditionally optimal cut-off values are found by weighting sensitivity and specificity equally. As this might result in too many unnecessary colonoscopies we also provide optimal cut-off values for different weighting of sensitivity and specificity/number of needed colonoscopies to detect one cancer.RESULTS: Weighting sensitivity and specificity equally gives an optimal cut-off value of 45 ng Hb/ml. This, however, means making 24 colonoscopies to detect one cancer. Weighting sensitivity lower and for example, aiming at making about 16 colonoscopies to detect one cancer, gives an optimal cut-off value of 125 ng Hb/ml.CONCLUSIONS: The optimal cut-off value in an FIT population-based screening program is 45 ng Hb/ml, when as traditionally sensitivity and specificity are weighted equally. If, however, 24 colonoscopies needed to detect one cancer is too huge a burden on the health care system and the participants, 80, 125, 175, and 350 ng Hb/ml are optimal cut-off values when only 19/16/14/10 colonoscopies are accepted to find one cancer.

KW - capacity building

KW - colorectal neoplasms

KW - mass screening

KW - sensitivity

KW - specificity

UR - http://www.scopus.com/inward/record.url?scp=85100330431&partnerID=8YFLogxK

U2 - 10.1002/cam4.3761

DO - 10.1002/cam4.3761

M3 - Journal article

C2 - 33534955

VL - 10

SP - 1872

EP - 1879

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 5

ER -

ID: 61989377