Gender-specific cut-off levels in colorectal cancer screening with fecal immunochemical test: A population-based study of colonoscopy findings and costs
- Resource Type
- Authors
- Hanna Ribbing Wilén; Johannes Blom; Deborah Saraste
- Source
- Journal of medical screening. 28(4)
- Subject
- Male
medicine.medical_specialty
Colorectal cancer
Population
Colonoscopy
Gastroenterology
Feces
Internal medicine
medicine
Humans
Mass Screening
education
Early Detection of Cancer
education.field_of_study
medicine.diagnostic_test
business.industry
Health Policy
Public Health, Environmental and Occupational Health
medicine.disease
Population based study
Colorectal cancer screening
Fecal Immunochemical Test
Occult Blood
Female
business
Colorectal Neoplasms
- Language
- ISSN
- 1475-5793
Objective In the population-based Swedish regional colorectal cancer (CRC) screening program of Stockholm–Gotland using the fecal immunochemical test (FIT), gender-specific cut-off levels of fecal hemoglobin are applied, since previous studies have indicated a lower sensitivity of FIT for CRC in women. The aim was to evaluate the diagnostic yield and the screening costs overall and per detected CRC of this strategy. Methods All individuals aged 60–69 invited to screening in 2015–2017 were included. Cut-off level for positive FIT was 40 µg/g in women and 80 µg/g in men. Those with a positive FIT were referred to colonoscopy. The yield of CRC and screening cost for the study period were assessed and compared to cut-off levels of 80 µg/g in both genders. Results Approximately 230,000 individuals were invited. Overall participation rates were 72% in women and 65% in men ( p Conclusion The high rate of CRC detected in women in the lowest FIT category outweighs the minor reduction in screening costs if the same cut-off level was used as for men.