Gut Liver.  2018 Mar;12(2):183-189. 10.5009/gnl17030.

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

Affiliations
  • 1Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
  • 2Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. drcha@khu.ac.kr

Abstract

BACKGROUND/AIMS
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.

Keyword

Colonoscopy; Colorectal neoplasms; Fecal occult blood test; Quality; Screening

MeSH Terms

Adenoma
Colonoscopy
Colorectal Neoplasms*
Europe
Humans
Korea*
Male
Mass Screening*
United States
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