Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate

• Published in: Journal of medical screening 2019-06, Vol.26 (2), p.92-97
• Main Authors: Blom, Johannes, Löwbeer, Christian, Elfström, K. Miriam, Sventelius, Marika, Öhman, Daniel, Saraste, Deborah, Törnberg, Sven
• Format: Article
• Language: English
• ISSN: 0969-1413; 1475-5793
• DOI: 10.1177/0969141318804843

Objective Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs. Methods The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period. Results There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% (p