2013 U HDHB:16-06-26 HDHB:16-06-26 08:21:56.000 HDHB:16-06-26 utf8 0 Osu Text txt Computermedien c Online-Ressource cr 1973102285 10.1016/j.eclinm.2026.103835 KXP 1973102285 eng rda 2026 April 2026 https://doi.org/10.1016/j.eclinm.2026.103835 R H Volltext LF 34 https://www.sciencedirect.com/science/article/pii/S2589537026000829 H Volltext LF 34 Variation in diagnostic performance of fecal immunochemical test (FIT) by cutoffs used in screening programs globally Idris Ola, Teresa Seum, Sigrid V. Carlsson, Michael Hoffmeister, and Hermann Brenner 191379685X Tpv3 gnd/1352849062 piz Ola Idris VerfasserIn aut 1918715122 Tpv3 gnd/1357938993 piz Seum Teresa VerfasserIn aut Sigrid V. Carlsson VerfasserIn aut 560880820 Tpv1 gnd/134103726 277089565 piz Hoffmeister Michael 1973 VerfasserIn aut 691247005 Tpv3 gnd/1020516445 360642136 piz Brenner Hermann VerfasserIn aut 94 2026 4 103835 1-9 9 Diagramme Online verfügbar: 16. März 2026 Gesehen am 16.06.2026 Enthalten in 1035271834 Obv zdb/2946413-4 512181683 2589-5370 EClinicalMedicine Amsterdam Elsevier 2018 Online-Ressource 202600000940000999 s Colonoscopy s Colorectal cancer screening s FIT thresholds s Sensitivity s Specificity s Stool-based test Alle Personen wegen Universitätsbibliographie Heidelberg bitte stehen lassen! HDHB/16.06.2026 Background - Quantitative fecal immunochemical test (FIT) is widely used for colorectal cancer (CRC) screening, with substantial variation in positivity thresholds across countries. This study examines how these thresholds affect FIT's diagnostic performance for detecting CRC and advanced precancerous lesions (APCL). - Methods - We analyzed data from a single round screening of 7398 men and women aged 50-79 years, enrolled between 2008 and 2020 in the German BLITZ study, who provided a stool sample for FIT prior to screening colonoscopy. Using FIT positivity thresholds from 30 countries across five continents, we estimated positivity rates, sensitivities for CRC, APCL, and any advanced neoplasia (AN), as well as specificity for no AN, with colonoscopy as the reference standard. Subgroup analyses were conducted by age and sex. - Findings - FIT positivity thresholds across the included countries ranged from 8.5 (Belgium, Flanders) to 120 μg Hb/g feces (England, Wales and Northern Ireland). This wide range went along with very wide ranges of positivity rates and diagnostic performance parameters: positivity rate, 17.6% (95% CI: 16.7-18.5) to 2.6% (95% CI: 2.3-3.0); sensitivity for CRC, 98.1% (95% CI: 90.1-100.0) to 55.6% (41.4-69.1); sensitivity for APCL, 45.5% (95% CI: 41.9-49.0) to 12.2% (95% CI: 10.0-14.7); sensitivity for any AN, 48.9% (95% CI: 45.4-52.4) to 15.0% (95% CI: 12.7-17.7); specificity for no AN, 86.3% (95% CI: 85.5-87.2) to 98.9% (95% CI: 98.7-99.2). - Interpretation - The broad range of FIT positivity thresholds across countries goes along with very different diagnostic performance parameters. While this limits comparability of results between countries, our results underscore the potential of FIT as a flexible screening tool that can be adapted to the evolving healthcare system capacities in different countries. - Funding - German Research Council, the Federal Ministry of Education and Research, and the German Cancer Aid. 2013 PICA 16-06-26 16-06-26 08:21:56.000 HDHB:16-06-26 utf8 4978452279 16-06-26 l01 16/250 00 ds 14 s hd2026 00 s 1410508463 Tdi 340508469 wissenschaftlicher Artikel (Zeitschrift) 01 s per_5 02 s s_9 03 p 1937502252 Tdx Ola Idris 04 k 1416466967 Tdi 346466962 Medizinische Fakultät Heidelberg 04 s 1410501914 Tdi 34050191X Verfasser 04 s pos_1 04 p 1918715149 Tdx Seum Teresa 05 k 1416466967 Tdi 346466962 Medizinische Fakultät Heidelberg 05 s 1410501914 Tdi 34050191X Verfasser 05 s pos_2 05 p 1502733269 Tdi 432733264 Hoffmeister Michael 06 k 1416466967 Tdi 346466962 Medizinische Fakultät Heidelberg 06 s 1410501914 Tdi 34050191X Verfasser 06 s pos_4 06 p 1430642343 Tdi 360642349 Brenner Hermann 07 k 1416466967 Tdi 346466962 Medizinische Fakultät Heidelberg 07 k 143134298X Tdi 361342985 Netzwerk AlternsfoRschung (NAR) 07 s 1410501914 Tdi 34050191X Verfasser 07 s pos_5 07 33