Dataset Information

Risk-adjusted colorectal cancer screening using the FIT and routine screening data: development of a risk prediction model.

ABSTRACT: BACKGROUND:The faecal immunochemical test (FIT) is replacing the guaiac faecal occult blood test in colorectal cancer screening. Increased uptake and FIT positivity will challenge colonoscopy services. We developed a risk prediction model combining routine screening data with FIT concentration to improve the accuracy of screening referrals. METHODS:Multivariate analysis used complete cases of those with a positive FIT (?20??g?g-1) and diagnostic outcome (n=1810; 549 cancers and advanced adenomas). Logistic regression was used to develop a risk prediction model using the FIT result and screening data: age, sex and previous screening history. The model was developed further using a feedforward neural network. Model performance was assessed by discrimination and calibration, and test accuracy was investigated using clinical sensitivity, specificity and receiver operating characteristic curves. RESULTS:Discrimination improved from 0.628 with just FIT to 0.659 with the risk-adjusted model (P=0.01). Calibration using the Hosmer-Lemeshow test was 0.90 for the risk-adjusted model. The sensitivity improved from 30.78% to 33.15% at similar specificity (FIT threshold of 160??g?g-1). The neural network further improved model performance and test accuracy. CONCLUSIONS:Combining routinely available risk predictors with the FIT improves the clinical sensitivity of the FIT with an increase in the diagnostic yield of high-risk adenomas.

SUBMITTER: Cooper JA

PROVIDER: S-EPMC5785737 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Risk-adjusted colorectal cancer screening using the FIT and routine screening data: development of a risk prediction model.

Cooper Jennifer Anne JA Parsons Nick N Stinton Chris C Mathews Christopher C Smith Steve S Halloran Stephen P SP Moss Sue S Taylor-Phillips Sian S

British journal of cancer 20171102 2

<h4>Background</h4>The faecal immunochemical test (FIT) is replacing the guaiac faecal occult blood test in colorectal cancer screening. Increased uptake and FIT positivity will challenge colonoscopy services. We developed a risk prediction model combining routine screening data with FIT concentration to improve the accuracy of screening referrals.<h4>Methods</h4>Multivariate analysis used complete cases of those with a positive FIT (⩾20 μg g<sup>-1</sup>) and diagnostic outcome (n=1810; 549 can ...[more]

PMID: 29096402

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Dataset Information

Risk-adjusted colorectal cancer screening using the FIT and routine screening data: development of a risk prediction model.

Publications

Risk-adjusted colorectal cancer screening using the FIT and routine screening data: development of a risk prediction model.

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