Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea

• Published in: Gut and liver Vol. 12; no. 2; pp. 183 - 189
• Main Authors: Kim, Dae Ho, Cha, Jae Myung, Kwak, Min Seob, Yoon, Jin Young, Cho, Young-Hak, Jeon, Jung Won, Shin, Hyun Phil, Joo, Kwang Ro, Lee, Joung Il
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 15.03.2018; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Aged; colonoscopy; Colonoscopy - methods; Colonoscopy - statistics & numerical data; colorectal neoplasms; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - immunology; Early Detection of Cancer - methods; fecal occult blood test; Feces - chemistry; Female; Humans; Immunochemistry - methods; Intestinal Mucosa - pathology; Male; Middle Aged; Occult Blood; Original; Predictive Value of Tests; quality; Republic of Korea - epidemiology; screening; 내과학; Screening; Colorectal neoplasms; Fecal occult blood test; Colonoscopy; Quality
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl17030

Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program. In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital. Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p＜0.001). The quality metrics used in the United States and Europe may be directly introduced to other countries, including Korea. However, the optimal quality metrics should be established in each country.