Risk factors for false positive and for false negative test results in screening with fecal occult blood testing
Risk factors for false positive and for false negative test results in screening with fecal occult blood testing
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DOI：
10.1002/ijc.28242
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发表时间：
2013-11-15
影响因子：
6.4
通讯作者：
Bossuyt, Patrick M.
中科院分区：
文献类型：
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作者：
Stegeman, Inge;de Wijkerslooth, Thomas R.;Bossuyt, Patrick M.
亚组间粪便免疫化学试验（FIT）假阴性或假阳性风险的差异可能会影响最佳筛查策略。我们评估亚组是否存在假阳性或假阴性FIT结果的风险增加，这种风险的变化是否与FIT敏感性和特异性的差异或与既往CRC风险的差异相关。随机选择无症状的个体进行结肠镜检查。参与者被要求接受一次样本FIT并完成一份风险调查问卷。我们使用逻辑回归确定了与假阴性和假阳性FIT结果相关的患者特征。我们关注的是统计学上的显著差异以及影响假阳性或假阴性风险的变量，其比值比超过1.25。在1，426名筛查参与者中，1，112名（78%）完成了FIT和问卷调查; 101名（9.1%）患有晚期肿瘤。102名个体为FIT阳性，65名（64%）有假阴性FIT结果，66名（65%）有假阳性FIT结果。年龄较大和吸烟者的参与者出现假阴性FIT结果的风险显著较高。男性出现假阳性结果的风险增加，吸烟者和常规NSAID使用者也是如此。女性的FIT敏感性较低。男性、吸烟者和常规NSAID使用者的特异性较低。女性的FIT敏感性较低。FIT特异性在男性、吸烟者和常规NSAID使用者中较低。我们的研究结果可用于进一步的证据为基础的个性化筛选策略。粪便免疫化学检测（FIT）在结肠直肠癌（CRC）筛查计划中用作结肠镜检查的非侵入性分诊检测。在这项研究中，作者检查了某些人群是否会增加FIT结果不准确的风险。他们发现，男性，吸烟者和经常使用NSAID的人有更高的假阳性结果率，而吸烟者和老年人的假阴性FIT的机会更高。女性的敏感性也较低。这些结果可能有助于改进CRC筛查策略。
Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.What's new? Fecal immunochemical testing (FIT) is used as a non-invasive triaging test for colonoscopy in screening programs for colorectal-cancer (CRC). In this study, the authors examined whether certain subgroups of people have an increased risk of inaccurate FIT results. They found that men, smokers and regular NSAID users had higher rates of false-positive results, while the chances of having a false negative FIT are higher in smokers and in people at advanced age. Sensitivity was also lower in women. These results may be useful for improving CRC screening strategies.