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Article Abstract
Background And Aims: The quantitative fecal immunochemical test (qnFIT) provides details of hemoglobin concentration, allowing for the adjustment of the positivity threshold to align with specific colorectal cancer (CRC) screening objectives. However, the superiority of qnFIT over qualitative fecal immunochemical test (qlFIT) extensively utilized throughout China is not thoroughly investigated.
Methods: 7097 residents were enrolled for the project, of which 5841 participants aged 50-74-year-old completed both qlFIT and qnFIT. All participants positive with either FIT were referred for colonoscopy. Positivity, uptake of colonoscopy, detection rate (DR) at colonoscopy, positive predictive value (PPV), DR in population and number needed to scope (NNS) were used to compare screening performance.
Results: Using the conventional 100 ng/ml as cut-off, positivity was 5.87% for qnFIT and 12.86% for qlFIT (P<0.001). CRC DR at colonoscopy and PPV for qnFIT were nearly twofold of corresponding values for qlFIT (DR 13.29% vs 7.52%, P=0.043; PPV 6.12% vs 3.20%, P=0.024), but DRs of adenoma and polyp in population with qnFIT were lower. 7.52 colonoscopies were needed to detect one CRC with qnFIT, almost half of that with qlFIT (7.52 vs 13.29, P=0.043).
Conclusions: QnFIT exhibited lower positivity, higher DR at colonoscopy and PPV for CRC over qlFIT. Almost half of colonoscopy resources were saved by qnFIT, although adenoma and polyp were missed in population screening.
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