A214 AN ANALYSIS OF FIT RESULTS AND NEOPLASTIC FINDINGS FROM THE NEWFOUNDLAND AND LABRADOR COLON CANCER SCREENING PROGRAM
Notice bibliographique
Résumé
Fecal Immunochemical Testing (FIT) is currently used in a number of Canadian provinces to screen for colorectal cancer. The Canadian Partnership Against Cancer (CPAC) recommends a FIT positive predictive value for neoplasia be >50%. Newfoundland and Labrador currently does not triage its colonoscopy waitlist for colorectal cancer screening beyond having one FIT value ≥100ng/mL. The aim of this study is to assess the effectiveness of different FIT cut-offs and combinations of FIT cut-offs in predicting adenomas and colorectal cancer. Data for this study was obtained in a prospective fashion using the Newfoundland and Labrador Colon Cancer Screening Program. Those enrolled in the study were between the ages of 50–74 at average risk for colon cancer. Between July 1, 2012 and June 30, 2016, participants were provided with two FIT tests – if a minimum of one test was ≥100ng/mL, participants were further evaluated via colonoscopy. Data on the patient’s age, gender, FIT value, presence of adenoma, pathology, and other variables were collected. Of the 21,371 FIT kits mailed out, 16,152 (75.6%) were returned, of which, 2694 (16.7%) had at least one FIT value ≥100ng/mL. The highest positive FIT values ranged from 100 to 54,017, with a mean of 942.3, 25th percentile of 145, 50th percentile of 260, and 75th percentile of 576. At the time of analysis, 1831 participants had been further evaluated by colonoscopy. Of those who had a colonoscopy, 73 (4.0%) were found to have colorectal cancer and 1092 (59.6%) were found to have an adenoma. The positive predictive value for both adenomas and colorectal cancer increased with increasing FIT values and serial positive values. Those with two FIT values ≥5000ng/mL had the highest adenoma detection rate (100.0%) and highest rate of colorectal cancer (53.8%), which was significantly higher than those with one FIT value ≥100ng/mL (p-values 0.002 and ≤0.001, respectively). There is a limited amount of Canadian research evaluating the performance of FIT testing within colorectal cancer screening programs. This research suggests that by increasing the FIT cut-off there is an improvement in adenoma detection rate. Patients with two FIT positive results are more likely to have colon cancer or an adenoma compared to patients with only one FIT positive result. Further triaging of colonoscopy wait lists could be considered based on quantitative FIT values and number of positive tests thus reducing the time to diagnosis for patients most likely to have colorectal cancer. Table 1. Colonoscopy Results by FIT Cutoff None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».