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The cumulative risk of false-positive fecal occult blood test after 10 years of colorectal cancer screening.

ABSTRACT: Annual colorectal cancer screening with fecal occult blood test (FOBT) is a noninvasive alternative to screening colonoscopy once every 10 years. If false-positive FOBT results are common, then many patients selecting an FOBT regimen will be exposed to the same invasive testing as those selecting a colonoscopy regimen. The objective of this study was to estimate the probability of experiencing a false-positive after receiving annual FOBT screening for 10 years.Medical records for patients aged 50 to 79 years receiving FOBT screening with Hemoccult Sensa between 1997 and 2009 at Group Health of Washington State captured the date and results of each FOBT, along with subsequent colorectal cancer diagnoses. We used logistic regression to analyze associations between patient characteristics and odds of a positive FOBT with no invasive cancer diagnosis within 1 year (FOBT+, CRC-). We estimated the probability of receiving at least one FOBT+, CRC- result after 10 years of screening.We observed 181,950 FOBTs from 94,637 individuals. Older patients, males, and non-White patients were significantly more likely to receive FOBT+, CRC- results (P < 0.001 for all risk factors). After 10 years of annual FOBT, 23.0% [95% confidence interval (CI), 18.2-27.0] will receive at least one FOBT+, CRC- result.Most patients participating in annual FOBT screening for 10 years will not have a positive result, reinforcing the potential value of this regimen as a noninvasive alternative to colonoscopy.Annual stool-based screening is a screening alternative resulting in substantially fewer colonoscopies than once per decade colonoscopy.

SUBMITTER: Hubbard RA

PROVIDER: S-EPMC3770276 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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The cumulative risk of false-positive fecal occult blood test after 10 years of colorectal cancer screening.

Hubbard Rebecca A RA Johnson Eric E Hsia Raymond R Rutter Carolyn M CM

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20130718 9

<h4>Background</h4>Annual colorectal cancer screening with fecal occult blood test (FOBT) is a noninvasive alternative to screening colonoscopy once every 10 years. If false-positive FOBT results are common, then many patients selecting an FOBT regimen will be exposed to the same invasive testing as those selecting a colonoscopy regimen. The objective of this study was to estimate the probability of experiencing a false-positive after receiving annual FOBT screening for 10 years.<h4>Methods</h4> ...[more]

PMID: 23868091

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Project description:False-positive mammography results are common. Biennial screening may decrease the cumulative probability of false-positive results across many years of repeated screening but could also delay cancer diagnosis.To compare the cumulative probability of false-positive results and the stage distribution of incident breast cancer after 10 years of annual or biennial screening mammography.Prospective cohort study.7 mammography registries in the National Cancer Institute-funded Breast Cancer Surveillance Consortium.169,456 women who underwent first screening mammography at age 40 to 59 years between 1994 and 2006 and 4492 women with incident invasive breast cancer diagnosed between 1996 and 2006.False-positive recalls and biopsy recommendations stage distribution of incident breast cancer.False-positive recall probability was 16.3% at first and 9.6% at subsequent mammography. Probability of false-positive biopsy recommendation was 2.5% at first and 1.0% at subsequent examinations. Availability of comparison mammograms halved the odds of a false-positive recall (adjusted odds ratio, 0.50 [95% CI, 0.45 to 0.56]). When screening began at age 40 years, the cumulative probability of a woman receiving at least 1 false-positive recall after 10 years was 61.3% (CI, 59.4% to 63.1%) with annual and 41.6% (CI, 40.6% to 42.5%) with biennial screening. Cumulative probability of false-positive biopsy recommendation was 7.0% (CI, 6.1% to 7.8%) with annual and 4.8% (CI, 4.4% to 5.2%) with biennial screening. Estimates were similar when screening began at age 50 years. A non-statistically significant increase in the proportion of late-stage cancers was observed with biennial compared with annual screening (absolute increases, 3.3 percentage points [CI, -1.1 to 7.8 percentage points] for women age 40 to 49 years and 2.3 percentage points [CI, -1.0 to 5.7 percentage points] for women age 50 to 59 years) among women with incident breast cancer.Few women underwent screening over the entire 10-year period. Radiologist characteristics influence recall rates and were unavailable. Most mammograms were film rather than digital. Incident cancer was analyzed in a small sample of women who developed cancer.After 10 years of annual screening, more than half of women will receive at least 1 false-positive recall, and 7% to 9% will receive a false-positive biopsy recommendation. Biennial screening appears to reduce the cumulative probability of false-positive results after 10 years but may be associated with a small absolute increase in the probability of late-stage cancer diagnosis.National Cancer Institute.

Dataset Information

The cumulative risk of false-positive fecal occult blood test after 10 years of colorectal cancer screening.

Publications

The cumulative risk of false-positive fecal occult blood test after 10 years of colorectal cancer screening.

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