Guaiac faecal occult blood test performance at initial and repeat screens in the English Bowel Cancer Screening Programme
Guaiac faecal occult blood test performance at initial and repeat screens in the English Bowel Cancer Screening Programme
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DOI：
10.1038/bjc.2014.469
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发表时间：
2014-10-28
影响因子：
8.8
通讯作者：
Patnick, J.
中科院分区：
文献类型：
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作者：
Kearns, B.;Whyte, S.;Patnick, J.
背景：在许多国家，结直肠癌（CRC）的筛查依赖于使用愈创木粪隐血试验（gFOBT）进行重复检测。本研究旨在比较gFOBT性能措施之间的初始和重复screens.Methods：筛选摄取和结果的数据从英国肠癌筛查计划（BCSP）的2008年和2011年被使用。一个现有的CRC自然史模型被用来估计gFOBT的敏感性和特异性，以及不同的筛查策略的成本效益。结果：gFOBT的敏感性CRC估计从27.35%，在初始屏幕下降到20.22%，在重复屏幕。CRC的阳性预测值（8.4-7.2%）和检出率（0.19-0.14%）也有所下降。假设相同的性能措施的初始和重复屏幕导致高估gFOBT筛选的成本效益与其他screeningmodels.Conclusions相比：gFOBT筛选的性能指标一般较低，在重复屏幕相比，初始屏幕。使用gFOBT筛查CRC可能具有成本效益;然而，使用不同的筛查方式可能会带来额外的益处。今后对gFOBT的经济评价不应假设各轮筛查之间的敏感性相同。
Background: In many countries, screening for colorectal cancer (CRC) relies on repeat testing using the guaiac faecal occult blood test (gFOBT). This study aimed to compare gFOBT performance measures between initial and repeat screens.Methods: Data on screening uptake and outcomes from the English Bowel Cancer Screening Programme (BCSP) for the years 2008 and 2011 were used. An existing CRC natural history model was used to estimate gFOBT sensitivity and specificity, and the cost-effectiveness of different screening strategies.Results: The gFOBT sensitivity for CRC was estimated to decrease from 27.35% at the initial screen to 20.22% at the repeat screen. Decreases were also observed for the positive predictive value (8.4-7.2%) and detection rate for CRC (0.19-0.14%). Assuming equal performance measures for both the initial and repeat screens led to an overestimate of the cost effectiveness of gFOBT screening compared with the other screening modalities.Conclusions: Performance measures for gFOBT screening were generally lower in the repeat screen compared with the initial screen. Screening for CRC using gFOBT is likely to be cost-effective; however, the use of different screening modalities may result in additional benefits. Future economic evaluations of gFOBT should not assume equal sensitivities between screening rounds.