Document Type : Original Article(s)
Authors
1 Department of Internal Medicine, Gastroenterology Unit, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt
2 Department of General Surgery, Al-Hussein University Hospital. Al-Azhar University, Cairo, Egypt
3 Departement of Tropical Medicine, Zagazig University hospital, Zagazig, Egypt
Abstract
Background: Colorectal cancer (CRC) has a presumable low incidence in Egypt which did not rationalize for the development of screening programs up till now. The fecal immunochemical test (FIT) can facilitate colonoscopy uptake and increase enrollment in CRC screening programs. We aimed to explore the attitude of Egyptian individuals towards screening colonoscopy and establish the accuracy of FIT to detect advanced colonic neoplasia (AN).
Method: In this cross-sectional study, we offered a questionnaire to 1470 subjects with a family history of AN to establish their attitude towards the use of either direct colonoscopy (group A) or 2 step screening strategy; utilizing FIT followed by colonoscopy (Group B). Eventually, all included individuals underwent both FIT and colonoscopy.
Results: A total of 547 persons of the interviewed population (37.3 %) agreed to participate in the study, and group A cohorts were more likely to accept colonoscopy invitations. A single cycle FIT had a sensitivity of 76.2% a specificity of 92.2%, a positive predictive value of 28.1.2%, and a negative predictive value of 99%. The incidence of AN among the screened population was 3.9%, and CRC was found in 2 patients (0.4%).
Conclusion: Uptake of colonoscopy is more likely, if the invitation strategy was a direct colonoscopy invitation. A single-round FIT test had good sensitivity and specificity to detect AN. Egypt has a low incidence of CRC in individuals with a family history of CRC.
Keywords
How to cite this article:
Alwassief A, Bakr IS, Dawod HM. Utility of fecal immunochemical test in screening for colorectal cancer in Egyptian individuals with family history of advanced colonic neoplasia. Middle East J Cancer. 2023;14(1):162-9. doi: 10.30476/mejc.2022.91147.1610.
- Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56(2):106-30. doi: 10.3322/canjclin.56.2.106.
- Bishehsari F, Mahdavinia M, Vacca M, Malekzadeh R, Mariani-Costantini R. Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol. 2014;20(20):6055-72. doi: 10.3748/wjg.v20.i20.6055.
- Gado A, Ebeid B, Abdelmohsen A, Axon A. Colorectal cancer in Egypt is commoner in young people: Is this cause for alarm? Alexandria Journal of Medicine. 2014;50(3):197-201.doi: 10.1016/j.ajme.2013.03.003.
- Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58(3): 130-60. doi: 10.3322/CA.2007.0018.
- Chan JA, Meyerhardt JA, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, et al. Association of family history with cancer recurrence and survival among patients with stage III colon cancer. JAMA. 2008;299(21):2515- 23. doi: 10.1001/jama.299.21.2515
- Järvinen HJ, Aarnio M, Mustonen H, Aktan-Collan K, Aaltonen LA, Peltomäki P, et al. Controlled 15- year trial on screening for colorectal cancer in families with hereditary nonpolyposis colorectal cancer. Gastroenterology. 2000;118(5):829-34. doi: 10.1016/s0016-5085(00)70168-5.
- Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi-society task force on colorectal cancer. Am J Gastroenterol. 2017;112(7):1016-30. doi: 10.1038/ajg.2017.174.
- Robertson DJ, Lee JK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, et al. Recommendations on fecal immunochemical testing to screen for colorectal neoplasia: A consensus statement by the US multi-society task force on colorectal cancer. Gastroenterology. 2017;152(5):1217-37.e3. doi: 10.1053/j.gastro.2016.08.053.
- European Colorectal Cancer Screening Guidelines Working Group, von Karsa L, Patnick J, Segnan N, Atkin W, Halloran S, et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy. 2013;45(1):51- 9. doi: 10.1055/s-0032-1325997.
- Lisi D, Hassan C, Crespi M; AMOD Study Group. Participation in colorectal cancer screening with FOBT and colonoscopy: an Italian, multicentre, randomized population study. Dig Liver Dis. 2010;42(5):371-6. doi: 10.1016/j.dld.2009.07.019.
- Wardle J, Sutton S, Williamson S, Taylor T, McCaffery K, Cuzick J, et al. Psychosocial influences on older adults' interest in participating in bowel cancer screening. Prev Med. 2000;31(4):323-34. doi: 10.1006/pmed.2000.0725.
- Farraye FA, Wong M, Hurwitz S, Puleo E, Emmons K, Wallace MB, et al. Barriers to endoscopic colorectal cancer screening: are women different from men? Am J Gastroenterol. 2004;99(2):341-9. doi: 10.1111/j.1572- 0241.2004.04045.x.
- Nielsen JB, Berg-Beckhoff G, Leppin A. To do or not to do - a survey study on factors associated with participating in the Danish screening program for colorectal cancer. BMC Health Serv Res. 2021;21(1):43. doi: 10.1186/s12913-020-06023-6.
- Jilcott Pitts SB, Lea CS, May CL, Stowe C, Hamill DJ, Walker KT,et al. "Fault-line of an earthquake": a qualitative examination of barriers and facilitators to colorectal cancer screening in rural, Eastern North Carolina. J Rural Health. 2013;29(1):78-87. doi: 10.1111/j.1748-0361.2012.00424.x.
- Shapiro JA, Bobo JK, Church TR, Rex DK, Chovnick G, Thompson TD, et al. A Comparison of fecal immunochemical and high-sensitivity guaiac tests for colorectal cancer screening. Am J Gastroenterol. 2017;112(11):1728-35. doi: 10.1038/ajg.2017.285.
- Selby K, Jensen CD, Lee JK, Doubeni CA, Schottinger JE, Zhao WK, et al. Influence of varying quantitative fecal immunochemical test positivity thresholds on colorectal cancer detection: A community-based cohort study. Ann Intern Med. 2018;169(7):439-47. doi: 10.7326/M18-0244.
- Hol L, Wilschut JA, van Ballegooijen M, van Vuuren AJ, van der Valk H, Reijerink JC, et al. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels. Br J Cancer. 2009;100(7):1103-10. doi: 10.1038/sj.bjc.6604961.
- Bauer A, Riemann JF, Seufferlein T, Reinshagen M, Hollerbach S, Haug U, et al. Invitation to screening colonoscopy in the population at familial risk for colorectal cancer. Dtsch Arztebl Int. 2018;115(43):715- 22. doi: 10.3238/arztebl.2018.0715.
- Veruttipong D, Soliman AS, Gilbert SF, Blachley TS, Hablas A, Ramadan M, et al. Age distribution, polyps and rectal cancer in the Egyptian population-based cancer registry. World J Gastroenterol. 2012;18(30):3997-4003. doi: 10.3748/wjg.v18.i30. 3997.
- Khalil KA, Salama OE, El Zeiny NA, El din Khalil S, Esmail NF. A study of pattern of gastrointestinal malignant neoplasms in the last decade (1987-1996) in Alexandria. J Egypt Public Health Assoc. 1999;74(5- 6):503-27.
- Abou-Zeid AA, Jumuah WA, Ebied EF, Abd El Samee Atia KS, El Ghamrini Y, Somaie DA. Hereditary factors are unlikely behind unusual pattern of early - Onset colorectal cancer in Egyptians: A study of family history and pathology features in Egyptians with large bowel cancer (cross-sectional study). Int J Surg. 2017;44:71-5. doi: 10.1016/j.ijsu.2017.06.028.
- Terhaar Sive Droste JS, Craanen ME, van der Hulst RW, Bartelsman JF, Bezemer DP, Cappendijk KR, et al. Colonoscopic yield of colorectal neoplasia in daily clinical practice. World J Gastroenterol. 2009;15(9): 1085-92. doi: 10.3748/wjg.15.1085.
- Puente Gutiérrez JJ, Marín Moreno MA, Domínguez Jiménez JL, Bernal Blanco E, Díaz Iglesias JM. Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer. Colorectal Dis. 2011;13(6):e145-53. doi: 10.1111/j.1463-1318.2011.02577.x.
- Cottet V, Pariente A, Nalet B, Lafon J, Milan C, Olschwang S, et al. Colonoscopic screening of firstdegree relatives of patients with large adenomas: increased risk of colorectal tumors. Gastroenterology. 2007;133(4):1086-92. doi: 10.1053/j.gastro.2007.07. 023.
- Fatemi SR, Shivarani S, Malek FN, Vahedi M, Maserat E, Iranpour Y, et al. Colonoscopy screening results in at risk Iranian population. Asian Pac J Cancer Prev. 2010;11(6):1801-4.
- Kaku E, Oda Y, Murakami Y, Goto H, Tanaka T, Hasuda K, et al. Proportion of flat- and depressedtype and laterally spreading tumor among advanced colorectal neoplasia. Clin Gastroenterol Hepatol. 2011;9(6):503-8. doi: 10.1016/j.cgh.2011.03.018.