Symptom or faecal immunochemical test based referral criteria for colorectal cancer detection in symptomatic patients: a diagnostic tests study
dc.contributor.author | Herrero, Jesús-Miguel | |
dc.contributor.author | Vega, Pablo | |
dc.contributor.author | Salve, María | |
dc.contributor.author | Bujanda Fernández de Pierola, Luis | |
dc.contributor.author | Cubiella, Joaquín | |
dc.date.accessioned | 2018-12-13T13:01:35Z | |
dc.date.available | 2018-12-13T13:01:35Z | |
dc.date.issued | 2018-10-25 | |
dc.identifier.citation | BMC Gastroenterology 18 : (2018) // Article ID 155 | es_ES |
dc.identifier.issn | 1471-230X | |
dc.identifier.uri | http://hdl.handle.net/10810/30330 | |
dc.description.abstract | BackgroundSymptom based referral criteria for colorectal cancer (CRC) detection are the cornerstone of the strategy to improve prognosis in CRC. In 2017, the National Institute for Health and Care Excellence (NICE) updated their referral criteria (2017 NG12). Recently, several studies have evaluated the faecal haemoglobin (f-Hb) concentration in this setting. The aim of this study is to evaluate the diagnostic accuracy of the 2017 NG12 referral criteria and to compare them with the CG27 referral criteria, the f-Hb concentration and two f-Hb based prediction model: COLONPREDICT and FAST Score.MethodsThis is a post-hoc diagnostic test study performed within the COLONPREDICT study database (1572 patients, CRC prevalence 13.6%). We assessed symptoms, the 2017 NG12 and CG27 referral criteria and determined the f-Hb before performing a colonoscopy. We compared the discriminatory ability using the area under the curve (AUC) and the sensitivity and specificity at pre-stablished thresholds with the McNemar's test.ResultsThe 2017 NG12 referral criteria discriminatory ability (AUC 0.53; 95% confidence interval- CI 0.49-0.57) was inferior to the CG27 version (AUC 0.59; 95% CI 0.55-0.63; p=0.01), the f-Hb concentration (AUC 0.86; 95% CI 0.84-0-89; p<0.001), the COLONPREDICT Score (AUC 0.92; 95% CI 0.91-0.94; p<0.001) or the FAST Score (AUC 0.87; 95% CI 0.85-0.89; p<0.001). The number of patients meeting each criteria were as follows: 2017 NG12 and CG27=94.1% and 52.2%; f-Hb 20 and10g/g faeces=38.6 and 44.3%; COLONPREDICT Score5.6 and3.2=29.4 and 63.2% and FAST Score4.50 and2.12=37.1 and 87.0%. The 2017 NG12 criteria were more sensitive (100%) than the CG27 criteria (68.2%), the f-Hb (20g/g) (91.2%), the f-Hb (10g/g) (93.5%), the COLONPREDICT Score (5.6) (90.1%) and the FAST Score (4.50) (89.8%) (p0.001) and equivalent to the COLONPREDICT Score (3.5) (99.5%) or the FAST Score (2.12) (100.0%) (p=1). However, their specificity (6.8%) was significantly lower than any of the evaluated criteria (50.3%, 69.6%, 63.4%, 78.7%, 45.8%, 71.3%, 13.9%; p<0.001).ConclusionReferral criteria based on f-Hb measurement, either as a single test or within prediction models, are more accurate than symptom-based referral criteria for CRC detection in symptomatic patients. | es_ES |
dc.description.sponsorship | This study was supported by a grant from Instituto de Salud Carlos III, Madrid, Spain (PI11/00094). Instituto de Salud Carlos III had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. JC has received an intensification grant through the European Commission funded "BIOCAPS" project (FP-7-REGPOT 2012-2013-1, Grant agreement no. FP7-316265). | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Biomed Central | es_ES |
dc.relation | info:eu-repo/grantAgreement/EC/FP7/316265 | es_ES |
dc.rights | info:eu-repo/semantics/openAccess | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | * |
dc.subject | colorectal cancer | es_ES |
dc.subject | faecal immunochemical test | es_ES |
dc.subject | diagnostic accuracy | es_ES |
dc.subject | risk stratification | es_ES |
dc.subject | hemoglobin concentration | es_ES |
dc.subject | indicators | es_ES |
dc.subject | accuracy | es_ES |
dc.subject | disease | es_ES |
dc.subject | system | es_ES |
dc.title | Symptom or faecal immunochemical test based referral criteria for colorectal cancer detection in symptomatic patients: a diagnostic tests study | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.holder | The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | es_ES |
dc.rights.holder | Atribución 3.0 España | * |
dc.relation.publisherversion | https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-018-0887-7 | es_ES |
dc.identifier.doi | 10.1186/s12876-018-0887-7 | |
dc.departamentoes | Medicina | es_ES |
dc.departamentoeu | Medikuntza | es_ES |
Files in this item
This item appears in the following Collection(s)
Except where otherwise noted, this item's license is described as The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.