Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med
Title: Biochemia Medica
Abbreviated Title: Biochem. Med.
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright: 2016, Croatian Society of Medical Biochemistry
Date received: 14 September 2015
Date accepted: 16 January 2016
Publication date (print and electronic): 15 February 2016
Volume: 26
Issue: 1
Pages: 114-120
Publisher ID: bm-26-114
DOI: 10.11613/BM.2016.012
Colorectal cancer detection in an asymptomatic population: fecal immunochemical test for hemoglobin vs. fecal M2-type pyruvate kinase
Gian Paolo Caviglia[1]
Luca Cabianca[2]
Sharmila Fagoonee[3]
Fabrizio M. Gili[2]
Author notes:
Corresponding author: fgili@cittadellasalute.to.it
Introduction
Screening programs for colorectal cancer (CRC) are mainly based on a first-line fecal immunochemical test for hemoglobin (FIT). Fecal M2-type pyruvate kinase (M2-PK) has been evaluated in clinical settings showing promising results for early CRC detection. However, the impact of fecal M2-PK assessment on the performance of first-round CRC screening programs is not known. We investigated whether fecal M2-PK alone or in combination with FIT may improve CRC screening efficacy in the general population.
Materials and methods
A total of 1027 asymptomatic subjects (median age 66 [59-74] years; females 504 [49.1%]), identified through the general practitioners’ rosters, were invited for the collection of 2 fecal samples for FIT and M2-PK evaluation. Participants with at least positive one fecal test were referred for colonoscopy. Quality indicators for screening performance were calculated and analyzed using Fisher’s exact test.
Results
Overall, 572 subjects underwent both FIT and M2-PK assessment (participation rate 55.7%): 93 participants showed positive results for at least one test (positivity rate 16.3%). Only 10 patients were positive for both tests. Attendance rate to colonoscopy was 86.0% and a total of 65 adenomas and 7 cancers were detected. Combined use of FIT and fecal M2-PK permitted the identification of 18 more neoplasm (25%) without improving colonoscopy workload, as deduced by the comparable number needed to scope (P = 0.402).
Keywords: biomarker; colorectal cancer; occult blood; M2-type pyruvate kinase; screening
