Most Read Articles
Pearl Toh, 31 Dec 2019
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Lowering FIT positivity threshold improves detection of advanced adenomas, colorectal carcinoma

06 Dec 2019

Positivity cutoff thresholds affect the efficacy of faecal immunochemical tests (FITs) in detecting colorectal carcinomas (CRCs) and advanced adenomas, reports a recent meta-analysis.

Accessing the databases of Medline and Embase, researchers retrieved 46 studies that employed FIT for CRC detection in asymptomatic adults. The resulting pooled sample included over 2.4 million participants, corresponding to 6,478 detected malignancies. Outcomes included sensitivity and specificity of the method and the number of cancers and advanced adenomas detected at different positivity thresholds.

At a positive threshold of >10 and 20 µg/g, FIT displayed a sensitivity of 69 percent. This climbed to 80 percent when the threshold was dropped to 10 µg/g. Specificity among those without malignancies, on the other hand, dropped from 94 percent to 91 percent.

For advanced adenoma alone, sensitivity increased from 21 percent to 31 percent as the threshold was lowered to 10 µg/g from >10 and 20 µg/g. Specificity dropped from 96 percent to 93 percent.

When using the primary positivity threshold employed in the different studies, the overall sensitivity and specificity of FIT for detecting the malignancies were 76 percent and 94 percent, respectively, with high heterogeneity. Excluding four studies with short follow-up durations did not change the accuracy estimates (76 percent and 93 percent, respectively) while decreasing heterogeneity.

In a theoretical population of 100,000 participants, researchers showed that dropping the positivity cutoff to <10 µg/g from >10 and 20 µg/g increased the number of detected CRC cases from 269 to 312, corresponding to a 16-percent jump. Detection of advanced adenoma improved by 43 percent, from 794 to 1,135 cases.

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
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Pearl Toh, 6 days ago
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12 Jan 2020
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.