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KMID : 1188320180120020183
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Gut and Liver
2018 Volume.12 No. 2 p.183 ~ p.189
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Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea
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Kim Dae-Ho
Cha Jae-Myung
Kwak Min-Seob
Yoon Jin-Young
Cho Young-Hak
Jeon Jung-Won
Shin Hyun-Phil
Joo Kwang-Ro
Lee Joung-Il
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Abstract
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Background/Aims: Knowledge regarding the quality metrics of fecal immunochemical test (FIT)-based colorectal cancer screening programs is limited. The aim of this study was to investigate the performance and quality metrics of a FIT-based screening program.
Methods: In our screening program, asymptomatic subjects aged ≥50 years underwent an annual FIT, and subjects with positive FIT results underwent a subsequent colonoscopy. The performance of the FIT and colonoscopy was analyzed in individuals with a positive FIT who completed the program between 2009 and 2015 at a university hospital.
Results: Among the 51,439 screened participants, 75.1% completed the FIT. The positive rate was 1.1%, and the colonoscopy completion rate in these patients was 68.6%. The positive predictive values of cancer and advanced neoplasia were 5.5% and 19.1%, respectively. The adenoma detection rate in the patients who underwent colonoscopy after a positive FIT was 48.2% (60.0% for men and 33.6% for women). The group with the highest tertile quantitative FIT level showed a significantly higher detection rate of advanced neoplasia than the group with the lowest tertile (odds ratio, 2.6; 95% confidence interval, 1.4 to 5.1; p＜0.001).
Conclusions: The quality metrics used in the United States and Europe may be directly introduced to other countries, including Korea. However, the optimal quality metrics should be established in each country.
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KEYWORD
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Colonoscopy, Colorectal neoplasms, Fecal occult blood test, Quality, Screening
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