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@ARTICLE{Gies:135955,
      author       = {A. Gies$^*$ and M. Bhardwaj$^*$ and C. Stock$^*$ and P.
                      Schrotz-King$^*$ and H. Brenner$^*$},
      title        = {{Q}uantitative fecal immunochemical tests for colorectal
                      cancer screening.},
      journal      = {International journal of cancer},
      volume       = {143},
      number       = {2},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2018-00692},
      pages        = {234 - 244},
      year         = {2018},
      abstract     = {Fecal immunochemical tests (FITs) for hemoglobin (Hb) are
                      increasingly used for colorectal cancer (CRC) screening. We
                      aimed to review, summarize and compare reported diagnostic
                      performance of various FITs. PubMed and Web of Science were
                      searched from inception to July 24, 2017. Data on diagnostic
                      performance of quantitative FITs, conducted in
                      colonoscopy-controlled average-risk screening populations,
                      were extracted. Summary receiver operating characteristic
                      (ROC) curves were plotted and correlations between
                      thresholds, positivity rates (PRs), sensitivities and
                      specificities were assessed. Seven test brands were
                      investigated across 22 studies. Although reported
                      sensitivities for CRC, advanced adenoma (AA) and any
                      advanced neoplasm (AN) varied widely (ranges: $25-100\%,$
                      $6-44\%$ and $9-60\%,$ respectively), with specificities for
                      AN ranging from $82\%$ to $99\%,$ the estimates were very
                      close to the respective summary ROC curves whose areas under
                      the curve $(95\%$ CI) were 0.905 (0.88-0.94), 0.683
                      (0.67-0.70) and 0.710 (0.70-0.72) for CRC, AA and AN,
                      respectively. The seemingly large heterogeneity essentially
                      reflected variations in test thresholds (range: 2-82 µg
                      Hb/g feces) and showed moderate correlations with
                      sensitivity (r = -0.49) and specificity (r = 0.60)
                      for AN. By contrast, observed PRs (range: $1-21\%)$ almost
                      perfectly correlated with sensitivity (r = 0.84) and
                      specificity (r = -0.94) for AN. The apparent large
                      heterogeneity in diagnostic performance between various FITs
                      can be almost completely overcome by appropriate threshold
                      adjustments. Instead of simply applying the threshold
                      recommended by the manufacturer, screening programs should
                      adjust the threshold to yield a desired PR which is a very
                      good proxy indicator for the specificity and the subsequent
                      colonoscopy workload.},
      subtyp        = {Review Article},
      cin          = {C070 / G110 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29277897},
      doi          = {10.1002/ijc.31233},
      url          = {https://inrepo02.dkfz.de/record/135955},
}