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Reduction of faecal immunochemical test false-positive results using a signature based on faecal bacterial markers.

Abstract：

BACKGROUND:Colorectal cancer is the second commonest cause of cancer mortality. Some countries are implementing colorectal cancer screening to detect lesions at an early stage using non-invasive tools like the faecal immunochemical test. Despite affordability, this test shows a low sensitivity for precancerous lesions and a low positive predictive value for colorectal cancer, resulting in a high false-positive rate. AIM:To develop a new, non-invasive colorectal cancer screening tool based on bacterial faecal biomarkers, which in combination with the faecal immunochemical test, could allow a reduction in the false-positive rate. This tool is called risk assessment of intestinal disease for colorectal cancer (RAID-CRC). METHODS:We performed both the faecal immunochemical test and the bacterial markers analysis (RAID-CRC test) in stool samples from individuals with normal colonoscopy (167), non-advanced adenomas (88), advanced adenomas (30) and colorectal cancer (48). All the participants showed colorectal cancer-associated symptoms. RESULTS:Performance of the faecal immunochemical test for advanced neoplasia (ie advanced adenoma and colorectal cancer) was determined by using the cut-off value established in Catalonia (20 µg haemoglobin/g of faeces) for a population-based screening approach. Sensitivity and specificity values of 83% and 80%, respectively, and positive and negative predictive values of 56% and 94%, respectively, were obtained. When both the immunological and the biological analysis were combined, the corresponding values were 80% and 90% for sensitivity and specificity, respectively, and 70% and 94% for positive and negative predictive values, respectively, resulting in a 50% reduction of the false-positive rate. CONCLUSIONS:RAID-CRC test allows a substantial reduction in the faecal immunochemical test false-positive results (50%) in a symptomatic population. Further validation is indicated in a colorectal cancer-screening scenario.

journal_name

Aliment Pharmacol Ther

journal_title

Alimentary pharmacology & therapeutics

authors

Malagón M,Ramió-Pujol S,Serrano M,Serra-Pagès M,Amoedo J,Oliver L,Bahí A,Mas-de-Xaxars T,Torrealba L,Gilabert P,Miquel-Cusachs JO,García-Nimo L,Saló J,Guardiola J,Piñol V,Cubiella J,Castells A,Aldeguer X,Garcia-Gil J

doi

10.1111/apt.15251

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

1410-1420

issue

eissn

0269-2813

issn

1365-2036

journal_volume

pub_type

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Reduction of faecal immunochemical test false-positive results using a signature based on faecal bacterial markers.