Related Experiment Video
Updated: Sep 10, 2025
Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Performance comparison of quantitative and qualitative fecal immunochemical tests in community-based colorectal
Xiaocong Zhang1, Jianming Dou1, Yangming Gong1
1Department of Cancer Control and Prevention, Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Background And Aims:
The quantitative fecal immunochemical test (qnFIT) provides details of hemoglobin concentration, allowing for the adjustment of the positivity threshold to align with specific colorectal cancer (CRC) screening objectives. However, the superiority of qnFIT over qualitative fecal immunochemical test (qlFIT) extensively used throughout China is not thoroughly investigated.
Methods:
A total of 7097 residents were enrolled for the project, of which 5841 participants aged 50 to 74 years completed both qlFIT and qnFIT. All participants positive with either fecal immunochemical test were referred for colonoscopy. Positivity, uptake of colonoscopy, detection rate (DR) at colonoscopy, positive predictive value (PPV), DR in population, and number needed to scope (NNS) were used to compare screening performance.
Results:
Using the conventional 100 ng/mL as cut-off, we found that positivity was 5.87% for qnFIT and 12.86% for qlFIT (P < .001). CRC DR at colonoscopy and PPV for qnFIT were nearly 2-fold of corresponding values for qlFIT (DR 13.29% vs 7.52%, P = .043, PPV 6.12% vs 3.20%, P = .024), but DRs of adenoma and polyp in population with qnFIT were lower. 7.52 colonoscopies were needed to detect one CRC with qnFIT, almost half of that with qlFIT (7.52 vs 13.29, P = .043).
Conclusions:
QnFIT exhibited lower positivity, greater DR at colonoscopy and PPV for CRC over qlFIT. Almost one half of colonoscopy resources were saved by qnFIT, although adenoma and polyp were missed in population screening.
