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@ARTICLE{Niedermaier:157533,
author = {T. Niedermaier$^*$ and Y. Balavarca$^*$ and H. Brenner$^*$},
title = {{S}tage-{S}pecific {S}ensitivity of {F}ecal
{I}mmunochemical {T}ests for {D}etecting {C}olorectal
{C}ancer: {S}ystematic {R}eview and {M}eta-{A}nalysis.},
journal = {The American journal of gastroenterology},
volume = {115},
number = {1},
issn = {0002-9270},
address = {Alphen aan den Rijn, The Netherlands},
publisher = {Wolters Kluwer Health, Inc.},
reportid = {DKFZ-2020-01688},
pages = {56 - 69},
year = {2020},
note = {in PubMed: Meta-Analysis#EA:C070#LA:C070#},
abstract = {Fecal immunochemical tests (FITs) detect the majority of
colorectal cancers (CRCs), but evidence for variation in
sensitivity according to the CRC stage is sparse and has not
yet been systematically synthesized. Thus, our objective was
to systematically review and summarize evidence on the
stage-specific sensitivity of FITs.We screened PubMed, Web
of Science, Embase, and the Cochrane Library from inception
to June 14, 2019, for English-language articles reporting on
the stage-specific sensitivity of FIT for CRC detection
using colonoscopy as a reference standard. Studies reporting
stage-specific sensitivities and the specificity of FIT for
CRC detection were included. Summary estimates of
sensitivity according to the CRC stage and study setting
(screening cohorts, symptomatic/diagnostic cohorts, and
case-control studies) were derived from bivariate
meta-analysis.Forty-four studies (92,447 participants
including 3,034 CRC cases) were included. Pooled
stage-specific sensitivities were overall very similar but
suffered from high levels of imprecision because of small
case numbers when calculated separately for screening
cohorts, symptomatic/diagnostic cohorts, and case-control
studies. Pooled sensitivities $(95\%$ confidence intervals)
for all studies combined were $73\%$ $(65\%-79\%)$ for
stage-I-CRCs and $80\%$ $(74\%-84\%),$ $82\%$ $(77\%-87\%),$
and $79\%$ $(70\%-86\%)$ for the detection of CRC stages II,
III, and IV, respectively. Even substantially larger
variation was seen in sensitivity by T-stage, with summary
estimates ranging from $40\%$ $(21\%-64\%)$ for T1 to $83\%$
$(68\%-91\%)$ for T3-CRC.Although FITs detect 4 of 5 CRCs at
stages II-IV, the substantially lower sensitivity for
stage-I-CRC and, in particular, T1 CRC indicates both need
and potential for further improvement in performance for the
early detection of CRC.},
subtyp = {Review Article},
keywords = {Biomarkers, Tumor: analysis / Colonoscopy / Colorectal
Neoplasms: diagnosis / Colorectal Neoplasms: metabolism /
Early Detection of Cancer: methods / Feces: chemistry /
Humans / Immunochemistry / Neoplasm Staging: methods /
Biomarkers, Tumor (NLM Chemicals)},
cin = {C070 / C120 / HD01},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31850933},
pmc = {pmc:PMC6946106},
doi = {10.14309/ajg.0000000000000465},
url = {https://inrepo02.dkfz.de/record/157533},
}