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@ARTICLE{Young:294592,
      author       = {G. P. Young and S. C. Benton and R. S. Bresalier and H.-M.
                      Chiu and E. Dekker and C. G. Fraser and M. A. M. Frasa and
                      S. P. Halloran and M. Hoffmeister$^*$ and S. Parry and K.
                      Selby and C. Senore and H. Singh and E. L. Symonds},
      title        = {{F}ecal {I}mmunochemical {T}est {P}ositivity {T}hresholds:
                      {A}n {I}nternational {S}urvey of {P}opulation-{B}ased
                      {S}creening {P}rograms.},
      journal      = {Digestive diseases and sciences},
      volume       = {70},
      issn         = {0002-9211},
      address      = {Dordrecht},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2024-02362},
      pages        = {1637–1645},
      year         = {2025},
      note         = {Volume 70, pages 1637–1645, (2025)},
      abstract     = {The fecal immunochemical test for hemoglobin (FIT) is now a
                      widely used non-invasive test in population-based organized
                      screening programs for colorectal neoplasia. The positivity
                      thresholds of tests currently in use are based on the fecal
                      hemoglobin concentration (f-Hb), but the rationale for the
                      adopted thresholds are not well documented. To understand
                      current global usage of FIT in screening programs we
                      conducted an international survey of the brands of FIT used,
                      the f-Hb positivity threshold applied and the rationale for
                      the choice.All members of the World Endoscopy Organization
                      CRC Screening Committee were invited to complete an
                      eight-element initial electronic survey exploring the key
                      aims. Responses were obtained from 63 individuals,
                      representing 38 specific locations in 28 countries. A
                      follow-up survey on technical issues was offered to the 38
                      locations, with replies from 17 sites in 13 countries.In-use
                      quantitative FIT were provided by four main manufacturers;
                      Minaris Medical (2 countries), Eiken Chemical
                      Company/Polymedco (21), Alfresa Pharma (2) and Sentinel
                      Diagnostics (4). Of the 38 screening sites, 15 used the
                      threshold of 20 µg hemoglobin/g feces, while thresholds
                      ranged between 8.5 and 120 ug/g in the remainder. Seven
                      explanations were given for adopted FIT thresholds;
                      maximizing the sensitivity for colorectal neoplasia (n = 23)
                      was the most common followed by the availability of
                      colonoscopy resources (n = 18). Predictive value,
                      specificity, and cost effectiveness were less frequently
                      reported as the rationale. Nine sites found it necessary to
                      change the threshold that they had initially selected.This
                      international survey has documented the wide range of FIT
                      positivity thresholds that are in current use. Quantitative
                      FITs enable programs to achieve the desired program outcomes
                      within available resource constraints by adjusting the
                      positivity threshold. This supports the need for enabling
                      positivity threshold adjustment of emerging new screening
                      tests based on novel predictive biomarkers, rather than
                      providing inflexible test endpoints.},
      subtyp        = {Review Article},
      keywords     = {Colorectal cancer (Other) / Non-invasive screening tests
                      (Other) / Population screening (Other) / Positivity
                      threshold (Other) / Quantitative fecal immunochemical test
                      (Other) / Screening program outcomes (Other)},
      cin          = {C070},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39528850},
      doi          = {10.1007/s10620-024-08664-7},
      url          = {https://inrepo02.dkfz.de/record/294592},
}