Addition of an online, validated family history questionnaire to the Dutch FIT-based screening programme did not improve its diagnostic yield
Menée aux Pays-Bas auprès de 5 979 personnes invitées à participer à un programme de dépistage du cancer colorectal (âge : 59 à 75 ans), cette étude évalue, du point de vue de la détection de néoplasies de stade avancé, l'intérêt d'ajouter un questionnaire sur les antécédents familiaux à une session de dépistage par test immunochimique de recherche de sang occulte dans les selles
Background : Faecal immunochemical testing (FIT) is suboptimal in detecting advanced neoplasia (AN). To increase the sensitivity and yield of a FIT-based screening programme, FIT could be combined with risk factors for AN. We evaluated the incremental yield of adding a family history questionnaire (FHQ) on colorectal cancer (CRC) and Lynch syndrome-associated tumours to the Dutch FIT-based screening programme.
Methods : Six thousand screen-naive individuals, aged 59–75 years, were invited to complete a FIT (FOB-Gold, cut-off 47 µg Hb/g faeces) and a validated online FHQ. Participants with a positive FIT and/or positive FHQ, confirmed after genetic counselling, were referred for colonoscopy. Yield of detecting AN per 1000 invitees for the combined strategy was compared with the FIT-only strategy.
Results : Of the 5979 invitees, 1952 (32.6%) completed the FIT only, 2379 (39.8%) completed both the FIT and FHQ and 95 (1.6%) completed the FHQ only. Addition of the FHQ to FIT-based screening resulted in one extra case of AN detected after 16 additional colonoscopies, resulting in a yield of 19.6 (95% CI, 16.4–23.5) for the combined strategy versus 19.5 (95% CI, 16.3–23.3) for the FIT-only strategy (p = 1.0).
Conclusions : The addition of an FHQ to one round of FIT screening did not increase the detection of AN compared with FIT only (ClinicalTrials.gov NCT02698462).
British Journal of Cancer , résumé, 2020