title: Sensitivity and Specificity of Community Fecal Immunotesting Screening for Colorectal Carcinoma in a High-Risk Canadian Population.
abstract: BACKGROUND
  Community-based programs are a common way of promoting colorectal cancer screening by primary care physicians. Fecal immunochemical testing (FIT) is a screening method commonly used in such programs. Fecal immunochemical testing has advantages to the patient as well as to clinical laboratories.
  
  
  OBJECTIVE
  To assess the operational test characteristics of a FIT pilot program in Calgary, Alberta, Canada, between April 2011 and May 2012.
  
  
  METHODS
  Four hundred fifty-seven high-risk patients undergoing both FIT and colonoscopy were included. Areas under the curve and positive predictive values were derived for FIT values and biopsy-proven neoplasia. Subgroup analysis was also performed on men and women and for ages older and younger than the mean age of 62 years.
  
  
  RESULTS
  For colorectal carcinoma and colonic adenomas the areas under the curve were 0.79 (95% confidence interval 0.71-0.87) and 0.60 (95% confidence interval 0.54-0.65), respectively. The positive predictive value of a positive FIT result for any neoplasia was 53%. The overall performance of the test for all neoplasia was better for men and better for older individuals.
  
  
  CONCLUSIONS
  The performance of FIT in this clinical setting was very good for detecting carcinoma, but marginal for detection of colonic adenomas.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Crouse
authors.forename: Lawrence
authors.initials: L
authors.lastname: De Koning
authors.forename: S M Hossein
authors.initials: SM
authors.lastname: Sadrzadeh
authors.affiliation: From Calgary Laboratory Services, Calgary, Alberta, Canada (Ms Crouse and Drs Koning, Sadrzadeh, and Naugler); and the Departments of Pathology and Laboratory Medicine (Ms Crouse and Drs Koning, Sadrzadeh, and Naugler) and Family Medicine (Dr Naugler), University of Calgary, Calgary, Alberta, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Naugler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003153:Community Health Services / Q000379:methods* / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity