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@ARTICLE{Gies:167436,
      author       = {A. Gies$^*$ and T. Niedermaier$^*$ and L. F. Gruner$^*$ and
                      T. Heisser$^*$ and P. Schrotz-King$^*$ and H. Brenner$^*$},
      title        = {{F}ecal {I}mmunochemical {T}ests {D}etect {S}creening
                      {P}articipants with {M}ultiple {A}dvanced {A}denomas
                      {B}etter than {T}1 {C}olorectal {C}ancers.},
      journal      = {Cancers},
      volume       = {13},
      number       = {4},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2021-00340},
      pages        = {644},
      year         = {2021},
      note         = {#EA:C120#LA:C070#},
      abstract     = {Fecal immunochemical tests (FITs) are widely used for
                      colorectal cancer (CRC) screening. The detection of
                      early-stage cancer and advanced adenoma (AA), the most
                      important premalignant lesion, is highly relevant to
                      reducing CRC-related deaths. We aimed to assess sensitivity
                      for the detection of CRC and AA stratified by tumor stage;
                      number; size; histology of AA; and by location, age, sex,
                      and body mass index (BMI).Participants of screening
                      colonoscopy (n = 2043) and newly diagnosed CRC patients (n =
                      184) provided a stool sample before bowel preparation or CRC
                      surgery. Fecal hemoglobin concentration was determined in
                      parallel by nine different quantitative FITs among 94 CRC
                      patients, 200 AA cases, and 300 participants free of
                      advanced neoplasm. Sensitivities were calculated at original
                      cutoffs and at adjusted cutoffs, yielding $93\%$ specificity
                      among all FITs.At adjusted cutoffs, UICC stage I cancers
                      yielded consistently lower sensitivities (range: $62-68\%)$
                      compared to stage II-IV cancers (range: $73-89\%).$ An even
                      stronger gradient was observed according to T status, with
                      substantially lower sensitivities for T1 (range: $39-57\%)$
                      than for T2-T4 cancers (range: $71-100\%).$ Sensitivities
                      for the detection of participants with multiple AAs ranged
                      from $55\%$ to $64\%$ and were by up to $25\%$ points higher
                      than sensitivities for T1 cancers.FITs detect stage I
                      cancers and especially T1 cancers at substantially lower
                      sensitivities than more advanced cancer stages. Participants
                      with multiple AAs were detected with slightly lower
                      sensitivities than stage I cancers and with even higher
                      sensitivities than T1 cancers. Further research should focus
                      on improving the detection of early-stage cancers.},
      keywords     = {advanced neoplasia (Other) / colon cancer (Other) / early
                      detection (Other) / fecal occult blood test (Other) /
                      prevention (Other)},
      cin          = {C120 / C070 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C120-20160331 / I:(DE-He78)C070-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33562775},
      doi          = {10.3390/cancers13040644},
      url          = {https://inrepo02.dkfz.de/record/167436},
}