Wang Shu-Yuan, Dong Xue-Tao, Yuan Zhen, Jin Lei-Xin, Gao Wei-Feng, Han You-Kui, Ni Ke-Min, Liu Zhao-Ce, Wang Jun-Ying, Wei Xiao-Meng, Su Xiao-Min, Peng Xi, Zhang Chun-Ze
School of Medicine, Nankai University, Tianjin 300071, China.
Department of Gastroenterology, Tianjin Union Medical Center, Tianjin 300121, China.
World J Gastrointest Oncol. 2025 Apr 15;17(4):101487. doi: 10.4251/wjgo.v17.i4.101487.
Certain subgroups are at an increased risk of false fecal immunochemical test (FIT) results; however, related studies are limited, and the available evidence is conflicting.
To evaluate factors associated with false-positive and false-negative FIT results.
This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020. A total of 4129947 residents aged 40-74 years completed at least one FIT. Of these, 24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis. Multivariable logistic regression was performed to identify the factors associated with false FIT results.
Among the overall screening population, 88687 (2.15%) participants tested positive for FIT. The sensitivity, specificity, positive predictive value, and negative predictive value of FIT for advanced neoplasms were 58.2%, 44.8%, 9.7%, and 91.3%, respectively. Older age, female sex, smoking, alcohol consumption, higher body mass index, and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of false-negative FIT results. Moreover, features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results, while irregular exercise and diverticulum were associated with higher odds of false-positive results.
FIT results may be inaccurate in certain subgroups. Our results provide important evidence for further individualization of screening strategies.
某些亚组人群出现粪便免疫化学试验（FIT）结果假阳性的风险增加；然而，相关研究有限，现有证据相互矛盾。
评估与FIT假阳性和假阴性结果相关的因素。
这项回顾性研究基于2012年至2020年天津市结直肠癌筛查项目的数据库。共有4129947名40 - 74岁的居民完成了至少一次FIT。其中，24890名无症状参与者接受了结肠镜检查并完成了生活方式问卷，纳入分析。采用多变量逻辑回归分析确定与FIT假结果相关的因素。
在整个筛查人群中，88687名（2.15%）参与者FIT检测呈阳性。FIT对晚期肿瘤的敏感性、特异性、阳性预测值和阴性预测值分别为58.2%、44.8%、9.7%和91.3%。年龄较大、女性、吸烟、饮酒、较高的体重指数和痔疮与FIT假阳性几率增加及假阴性几率降低显著相关。此外，高级别上皮内瘤变或晚期腺瘤的绒毛状特征以及癌症的存在也与假阴性结果几率降低相关，而不定期运动和憩室与假阳性结果几率增加相关。
FIT结果在某些亚组中可能不准确。我们的结果为进一步个体化筛查策略提供了重要证据。
