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Diagnostics
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Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond
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Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 9787

Special Issue Editor

Dr. Joaquin Cubiella

E-Mail Website
Guest Editor
Department of Gastroenterology, Hospital Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Ourense, Spain
Interests: colorectal cancer diagnosis and prevention; fecal immunochemical test; colorectal cancer diagnostic biomarkers; colorectal cancer predisposition; colorectal adenomas; endoscopy

Special Issue Information

Dear Colleagues,

Fecal immunochemical tests are the most widely used colorectal cancer diagnostic biomarker. There is ample evidence on the use of this biomarker as a colorectal cancer screening test. However, in recent years, multiple research has been published regarding their use in the colorectal cancer diagnosis as well as in alternative settings: surveillance after adenoma resection. The aim of this Special Issue is to explore the advantages and limitations of fecal immunochemical tests in the diagnosis and prevention of colorectal cancer. We will also accept articles regarding other issues, such as colorectal cancer risk stratification using fecal immunochemical tests, concomitant use with other biomarkers, or comparison of fecal immunochemical tests with other available biomarkers.

Dr. Joaquin Cubiella
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • fecal immunochemical test
  • colorectal cancer screening
  • colorectal cancer diagnosis
  • surveillance after adenoma resection
  • risk stratification

Published Papers (4 papers)

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Research

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9 pages, 504 KiB  
Article
Faecal Immunochemical Test Impact on Prognosis of Colorectal Cancer Detected in Symptomatic Patients
by Jesús Daniel Fernández de Castro, Franco Baiocchi Ureta, Raquel Fernández González, Noel Pin Vieito and Joaquín Cubiella Fernández
Diagnostics 2022, 12(4), 1013; https://doi.org/10.3390/diagnostics12041013 - 17 Apr 2022
Viewed by 1600
Abstract
The use of the faecal immunochemical test (FIT) to stratify the risk of colorectal cancer (CRC) in symptomatic patients in primary healthcare enables improved referrals to colonoscopy. However, its effect on diagnostic delays or the prognosis of patients has been poorly evaluated in [...] Read more.
The use of the faecal immunochemical test (FIT) to stratify the risk of colorectal cancer (CRC) in symptomatic patients in primary healthcare enables improved referrals to colonoscopy. However, its effect on diagnostic delays or the prognosis of patients has been poorly evaluated in this setting. We performed a retrospective cohort study that included symptomatic patients with outpatient CRC diagnosis between 2009 and 2017. We identified whether FIT had been analysed between initial healthcare contact and diagnostic confirmation. We included 589 patients (male = 65%, 71.7 ± 11.6 years, TNM IV = 17.1%) in the analysis. FIT was performed in 411 (69.8%) patients with a positive result (≥10 µg/g of faeces) in 96.4% of the evaluated patients. The use of FIT was associated with increased diagnostic delay (yes = 159 ± 277 days, no = 111 ± 172 days; p = 0.01). At five years follow up, 193 (32.8%) patients died (151 due to CRC). Mean survival was not modified by the use of FIT or its result (not performed = 46.8 ± 1.5 months, FIT+ = 48.9 ± 1 months, FIT− = 45.6 ± 5.5 months; p = 0.5) in Kaplan–Meier analysis, and was confirmed later in multivariate Cox regression analysis. In conclusion, FIT determination in symptomatic patients in primary healthcare did not modify CRC prognosis. Full article
(This article belongs to the Special Issue Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond)
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10 pages, 846 KiB  
Article
A Patient Self-Made Point-of-Care Fecal Test Improves Diagnostic Accuracy Compared with Fecal Calprotectin Alone in Inflammatory Bowel Disease Patients
by Gonzalo Hijos-Mallada, Raul Velamazán, Raúl Marti, Eduardo Chueca, Samantha Arechavaleta, Alberto Lué, Fernando Gomollón, Angel Lanas and Carlos Sostres
Diagnostics 2021, 11(12), 2323; https://doi.org/10.3390/diagnostics11122323 - 10 Dec 2021
Cited by 1 | Viewed by 2619
Abstract
Background: Monitoring inflammatory bowel disease patients may be challenging. Fecal calprotectin is one of the most performed tests. Other fecal biomarkers are less used in clinical practice. Rapid fecal tests that could be performed by patients may be a useful strategy to closely [...] Read more.
Background: Monitoring inflammatory bowel disease patients may be challenging. Fecal calprotectin is one of the most performed tests. Other fecal biomarkers are less used in clinical practice. Rapid fecal tests that could be performed by patients may be a useful strategy to closely monitor disease activity. Methods: We performed a prospective observational study including consecutive inflammatory bowel disease patients referred for colonoscopy in a single center. Certest FOB + Transferrin + Calprotectin + Lactoferrin® (Certest Biotec S.L, Zaragoza, Spain), a one-step point-of-care test which simultaneously detects these four biomarkers was performed. Endoscopic inflammatory activity was defined using the Mayo score (≥1) in ulcerative colitis, SES-CD (>3) and Rutgeerts scores (≥1) for Crohn’s disease. Results: Out of a total of 106 patients (56.5% female, mean age 51 years), 54 (50.9%) were diagnosed with ulcerative colitis and 52 (49.1%) with Crohn’s disease. Endoscopic activity was detected in 42 patients (39.0%). Fecal calprotectin provided the best sensitivity (97.6%), with limited specificity (34.4%). Compared to calprotectin, the other 3 fecal biomarkers showed better specificity (87.5–92.1%) and lower sensitivity (45.2–59.5%). Patients with a negative result in all biomarkers (19/106—17.9%) had 100% (CI 95% 97.4–100) negative predictive value, while patients with the 4 biomarkers positive (13/106—12.3%) had 100% (CI 95% 96.1–100) positive predictive value of endoscopic inflammatory activity. AUROC of this 4 biomarker point-of-care test was 0.845 (95% CI 0.771–0.920), significantly higher than the AUROCs of any of the 4 biomarkers. Conclusions: This test may be a useful strategy to monitor inflammatory activity in clinical practice by excluding or prioritizing patients in need of a colonoscopy. Full article
(This article belongs to the Special Issue Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond)
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Review

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9 pages, 249 KiB  
Review
Faecal Haemoglobin Estimated by Faecal Immunochemical Tests—An Indicator of Systemic Inflammation with Real Clinical Potential
by Karen N. Barnett, Gavin R. C. Clark, Robert J. C. Steele and Callum G. Fraser
Diagnostics 2021, 11(11), 2093; https://doi.org/10.3390/diagnostics11112093 - 12 Nov 2021
Cited by 14 | Viewed by 2079
Abstract
Multimorbidity is the major cause of ill-health and premature death in developed countries. The ability to identify individuals at risk of developing chronic disease, particularly multimorbidity, reliably, and simply, and to identify undiagnosed disorders, is vital to reducing the global burden of disease. [...] Read more.
Multimorbidity is the major cause of ill-health and premature death in developed countries. The ability to identify individuals at risk of developing chronic disease, particularly multimorbidity, reliably, and simply, and to identify undiagnosed disorders, is vital to reducing the global burden of disease. This narrative review, the first of recent studies, demonstrates that raised faecal haemoglobin concentration (f-Hb) is associated with increased all-cause and cause-specific mortality and with longer-term conditions including diabetes, hypertension, cardiovascular disease, and psoriasis, and with probable intake of particulate matter. We and others have hypothesized that elevated f-Hb (measured using a faecal immunochemical test) has considerable potential to identify individuals at risk of, or who already have, early stage, undiagnosed chronic disease. If f-Hb does prove to be an effective biomarker for chronic disease and multimorbidity, individuals with detectable f-Hb, but without an obvious source of gastrointestinal blood loss, could benefit from further assessment and early intervention. To test this hypothesis rigorously, longitudinal data-linkage methodology is required linking colorectal cancer screening data, and data on patients presenting with lower gastrointestinal symptoms, with routinely collected health information. Full article
(This article belongs to the Special Issue Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond)

Other

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9 pages, 771 KiB  
Study Protocol
Polyprev: Randomized, Multicenter, Controlled Trial Comparing Fecal Immunochemical Test with Endoscopic Surveillance after Advanced Adenoma Resection in Colorectal Cancer Screening Programs: A Study Protocol
by Cristina Regueiro, Raquel Almazán, Isabel Portillo, María Besó, Carlos Tourne-Garcia, Elena Rodríguez-Camacho, Akiko Ono, Ángel Gómez-Amorín and Joaquín Cubiella
Diagnostics 2021, 11(9), 1520; https://doi.org/10.3390/diagnostics11091520 - 24 Aug 2021
Cited by 8 | Viewed by 2651
Abstract
Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesion is detected, clinical practice guidelines recommend endoscopic surveillance with different intervals between explorations. Endoscopic surveillance is producing a considerable increase in the number [...] Read more.
Colorectal cancer (CRC) screening programs have been implemented to reduce the burden of the disease. When an advanced colonic lesion is detected, clinical practice guidelines recommend endoscopic surveillance with different intervals between explorations. Endoscopic surveillance is producing a considerable increase in the number of colonoscopies, with a limited effect on the CRC incidence. Instead, participation in CRC screening programs based on the fecal immunochemical test (FIT) could be a non-inferior alternative to endoscopic surveillance to reduce 10-year CRC incidence. Based on this hypothesis, we have designed a multicenter and randomized clinical trial within the Spanish population CRC screening programs to compare FIT surveillance with endoscopic surveillance. We will include individuals aged from 50 to 65 years with complete colonoscopy and advanced lesions resected within the CRC screening programs. Patients will be randomly allocated to perform an annual FIT and colonoscopy if fecal hemoglobin concentration is ≥10 µg/g, or to perform endoscopic surveillance. On the basis of the non-superior CRC incidence, we will recruit 1894 patients in each arm. The main endpoint is 10-year CRC incidence and the secondary endpoints are diagnostic yield, participation, adverse effects, mortality and cost-effectiveness. Our results may modify the clinical practice after advanced colonic resection in CRC screening programs. Full article
(This article belongs to the Special Issue Fecal Immunochemical Test: Colorectal Cancer Screening and Beyond)
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