2 research outputs found
Population-based colorectal cancer screening programmes using a faecal immunochemical test:Should faecal haemoglobin cut-offs differ by age and sex?
Abstract Background The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Methods Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50–69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. Results We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). Conclusions This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting the f-Hb cut-off
Recurrent presence of the PLCG1 S345F mutation in nodal peripheral T-cell lymphomas
This work was supported by grants from Asociación
Española contra el Cancer (AECC), Ministerio de Economía y
Competitividad (MINECO) (SAF2013-47416-R), Instituto Salud
Carlos III (ISCIII) – Fondos FEDER, MINECO-AES(RD012/0036/0060, PI10/00621, CP11/00018). RM is supported
by the Fundación Conchita Rábago de la Fundación Jiménez Díaz,
Madrid (Spain). JG-R is supported by a predoctoral grant from the
Fundacion Investigacion Biomedica Puerta de Hierro. Salary support to
SG is provided by ISCIII-FEDER (CP11/00018). MS-B is supported
by a Miguel Servet contract from ISCIII-FEDER (CP11/00018). The
Instituto de Investigación Marqués de Valdecilla (IDIVAL) is partly
funded by the Sociedad para el Desarrollo Regional de Cantabria
(SODERCAN)