000117192 001__ 117192
000117192 005__ 20240705134133.0
000117192 0247_ $$2doi$$a10.3389/fmed.2021.712040
000117192 0248_ $$2sideral$$a125746
000117192 037__ $$aART-2021-125746
000117192 041__ $$aeng
000117192 100__ $$0(orcid)0000-0003-1415-146X$$aAznar-Gimeno, R.
000117192 245__ $$aEvidence-based selection on the appropriate FIT cut-off point in CRC screening programs in the COVID pandemic
000117192 260__ $$c2021
000117192 5060_ $$aAccess copy available to the general public$$fUnrestricted
000117192 5203_ $$aBackground: The COVID pandemic has forced the closure of many colorectal cancer (CRC) screening programs. Resuming these programs is a priority, but fewer colonoscopies may be available. We developed an evidence-based tool for decision-making in CRC screening programs, based on a fecal hemoglobin immunological test (FIT), to optimize the strategy for screening a population for CRC. Methods: We retrospectively analyzed data collected at a regional CRC screening program between February/2014 and November/2018. We investigated two different scenarios: not modifying vs. modifying the FIT cut-off value. We estimated program outcomes in the two scenarios by evaluating the numbers of cancers and adenomas missed or not diagnosed in due time (delayed). Results: The current FIT cut-off (20-mu g hemoglobin/g feces) led to 6, 606 colonoscopies per 100, 000 people invited annually. Without modifying this FIT cut-off value, when the optimal number of individuals invited for colonoscopies was reduced by 10-40%, a high number of CRCs and high-risk adenomas (34-135 and 73-288/100.000-people invited, respectively) will be undetected every year. When the FIT cut-off value was increased to where the colonoscopy demand matched the colonoscopy availability, the number of missed lesions per year was remarkably reduced (9-36 and 29-145/100.000 people, respectively). Moreover, the unmodified FIT scenario outcome was improved by prioritizing the selection process based on sex (males) and age, rather than randomly reducing the number invited. Conclusions: Assuming a mismatch between the availability and demand for annual colonoscopies, increasing the FIT cut-off point was more effective than randomly reducing the number of people invited. Using specific risk factors to prioritize access to colonoscopies should be also considered.
000117192 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000117192 590__ $$a5.058$$b2021
000117192 592__ $$a1.179$$b2021
000117192 594__ $$a3.4$$b2021
000117192 591__ $$aMEDICINE, GENERAL & INTERNAL$$b53 / 172 = 0.308$$c2021$$dQ2$$eT1
000117192 593__ $$aMedicine (miscellaneous)$$c2021$$dQ1
000117192 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000117192 700__ $$aCarrera-Lasfuentes, P.
000117192 700__ $$0(orcid)0000-0003-2755-5500$$adel-Hoyo-Alonso, R.
000117192 700__ $$0(orcid)0000-0001-8741-6452$$aDoblare, M.$$uUniversidad de Zaragoza
000117192 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, A.$$uUniversidad de Zaragoza
000117192 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000117192 7102_ $$15004$$2605$$aUniversidad de Zaragoza$$bDpto. Ingeniería Mecánica$$cÁrea Mec.Med.Cont. y Teor.Est.
000117192 773__ $$g8 (2021), 712040 [10 pp.]$$pFront. med.$$tFrontiers in Medicine$$x2296-858X
000117192 8564_ $$s2200023$$uhttps://zaguan.unizar.es/record/117192/files/texto_completo.pdf$$yVersión publicada
000117192 8564_ $$s2346061$$uhttps://zaguan.unizar.es/record/117192/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000117192 909CO $$ooai:zaguan.unizar.es:117192$$particulos$$pdriver
000117192 951__ $$a2024-07-05-12:44:52
000117192 980__ $$aARTICLE