Table 2.
Diagnostic performance of FIT and APCS combined with FIT for detecting colorectal neoplasms among 3,407 participants
| Screening strategies (positivity threshold: APCS; FIT, μg Hb/g) | Positivity rate, % | Sensitivity, % (95% CI) | Specificity, % (95% CI) | PPV, % (95% CI) | NPV, % (95% CI) | ||||
| CRC | AA | AN | CRC | AA | AN | ||||
| FIT | |||||||||
| None; 10 | 3.8 | 57.1 (40.0–73.1) | 12.9 (9.6–16.9) | 17.3 (13.7–21.4) | 97.4 (96.9–97.8) | 12.2 (7.8–18.0) | 25.2 (19.0–32.2) | 37.4 (30.3–44.9) | 92.9 (92.1–93.6) |
| None; 20 | 2.8 | 57.1 (40.0–73.1) | 11.0 (7.9–14.7) | 15.5 (12.1–19.5) | 98.3 (97.9–98.7) | 16.7 (10.7–24.2) | 29.2 (21.6–37.7) | 45.8 (37.1–54.7) | 92.8 (92.0–93.5) |
| None; 30 | 2.2 | 57.1 (40.0–73.1) | 9.0 (6.2–12.5) | 13.8 (10.5–17.6) | 98.8 (98.4–99.1) | 21.1 (13.7–30.2) | 30.3 (21.6–40.1) | 51.3 (41.3–61.2) | 92.7 (91.9–93.4) |
| Risk-adapted screening methoda | |||||||||
| 3; 10 | 55.3 | 85.7 (70.2–95.0) | 75.3 (70.4–79.7) | 76.3 (71.8–80.4) | 46.6 (45.1–48.1) | 1.3 (0.9–1.8) | 10.2 (9.1–11.4) | 11.5 (10.3–12.7) | 95.6 (94.6–96.4) |
| 3; 20 | 54.8 | 85.7 (70.2–95.0) | 74.5 (69.6–79.0) | 75.6 (71.1–79.8) | 47.1 (45.6–48.5) | 1.3 (0.9–1.8) | 10.2 (9.0–11.4) | 11.5 (10.3–12.7) | 95.5 (94.5–96.4) |
| 3; 30 | 54.6 | 85.7 (70.2–95.0) | 74.1 (69.2–78.6) | 75.3 (70.7–79.4) | 47.3 (45.8–48.8) | 1.3 (0.9–1.8) | 10.2 (9.0–11.4) | 11.5 (10.3–12.7) | 95.5 (94.5–96.3) |
| 4; 10 | 34.4 | 71.4 (54.3–84.9) | 57.6 (52.3–62.8) | 59.0 (54.0–63.9) | 67.9 (66.5–69.2) | 1.7 (1.1–2.5) | 12.6 (11.0–14.3) | 14.3 (12.6–16.1) | 94.8 (94.0–95.6) |
| 4; 20 | 33.8 | 71.4 (54.3–84.9) | 56.5 (51.1–61.7) | 58.0 (52.9–62.9) | 68.4 (67.0–69.8) | 1.7 (1.2–2.5) | 12.5 (10.9–14.2) | 14.3 (12.6–16.1) | 94.7 (93.9–95.5) |
| 4; 30 | 33.4 | 71.4 (54.3–84.9) | 55.7 (50.3–60.9) | 57.2 (52.2–62.2) | 68.8 (67.4–70.1) | 1.8 (1.2–2.5) | 12.5 (10.9–14.2) | 14.2 (12.6–16.1) | 94.7 (93.8–95.4) |
| 5; 10 | 12.2 | 64.3 (47.0–79.2) | 27.1 (22.5–32.0) | 30.7 (26.2–35.6) | 89.5 (88.6–90.4) | 4.3 (2.8–6.4) | 16.6 (13.7–19.9) | 21.0 (17.7–24.5) | 93.4 (92.7–94.2) |
| 5; 20 | 11.2 | 64.3 (47.0–79.2) | 25.1 (20.7–30.0) | 29.0 (24.5–33.7) | 90.4 (89.5–91.2) | 4.7 (3.1–6.9) | 16.7 (13.6–20.2) | 21.4 (18.0–25.1) | 93.4 (92.6–94.1) |
| 5; 30 | 10.7 | 64.3 (47.0–79.2) | 23.5 (19.2–28.3) | 27.6 (23.2–32.3) | 90.8 (89.9–91.6) | 4.9 (3.2–7.2) | 16.4 (13.3–19.9) | 21.3 (17.8–25.1) | 93.3 (92.5–94.0) |
AA, advanced adenoma; AN, advanced neoplasm; APCS, Asia-Pacific Colorectal Screening; CI, confidence interval; CRC, colorectal cancer; FIT, fecal immunochemical test; NPV, negative predictive value; PPV, positive predictive value.
a
Risk-adapted screening method was conducted based on the APCS score. Subjects with scores at or greater than the positivity threshold were defined as high-risk and were referred for a colonoscopy; those with scores less than the positivity threshold were defined as low-risk and were referred for FIT screening.