Cross-sectional risk models using quantitative fecal hemoglobin in colorectal cancer screening: a systematic review.

IF 3.9 3区医学 Q1 PATHOLOGY Expert Review of Molecular Diagnostics Pub Date : 2023-07-01 Epub Date: 2023-12-15 DOI:10.1080/14737159.2023.2279607

Tim Kortlever, Willemijn de Klaver, Manon van der Vlugt, Gerrit Meijer, Evelien Dekker, Patrick Bossuyt

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Abstract

Introduction: Fecal Immunochemical Testing (FIT) is a central tool in colorectal cancer (CRC) screening. To improve the selection of individuals for colonoscopy, risk models combining FIT with additional CRC risk factors have been developed. This systematic review aims to provide an overview of the current noninvasive FIT-based risk models for CRC screening to facilitate future implementation.

Methods: We performed a systematic literature search for risk models that combined quantitative fecal hemoglobin with clinical data or noninvasive biomarkers and that were intended for CRC screening. Risk of bias was assessed using the PROBAST tool.

Results: Twenty risk models reported across 29 publications were included. The overall risk of bias was high. In studies that compared risk models to FIT, 11/12 (92%) risk models had a significantly higher c-statistic than FIT only. 16/20 risk models (80%) had not been externally validated and only one model has been implemented so far.

Conclusion: FIT-based risk models have the potential to improve the yield of CRC screening. Unfortunately, all included publications had a high risk of bias and most risk models have not yet been externally validated. The prospect of improved CRC screening with risk models should encourage more rigorous evaluation in existing screening programs.

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在结直肠癌癌症筛查中使用定量粪便血红蛋白的跨节风险模型：一项系统综述。

简介：粪便免疫化学检测（FIT）是癌症（CRC）筛查的核心工具。为了改进结肠镜检查的个体选择，已经开发了将FIT与其他CRC风险因素相结合的风险模型。本系统综述旨在概述目前基于非侵入性FIT的CRC筛查风险模型，以促进未来的实施。方法：我们进行了一项系统的文献检索，寻找将定量粪便血红蛋白与临床数据或非侵入性生物标志物相结合的用于CRC筛查的风险模型。使用PROBAST工具评估偏倚风险。结果：纳入了29份出版物中报告的20个风险模型。偏倚的总体风险很高。在将风险模型与FIT进行比较的研究中，11/12（92%）风险模型的c统计量显著高于仅FIT。16/20个风险模型（80%）尚未经过外部验证，迄今为止只实施了一个模型。结论：基于FIT的风险模型有可能提高CRC筛查的产率。不幸的是，所有收录的出版物都有很高的偏倚风险，大多数风险模型尚未经过外部验证。利用风险模型改进CRC筛查的前景应该鼓励对现有筛查项目进行更严格的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Molecular Diagnostics 医学-病理学

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

1 months

期刊介绍： Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting. Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy. Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.