Gender Differences in Fecal Immunochemical Test Performance for Early Detection of XXXX .

@entity1 @entity5 @entity14
BACKGROUND _ AIMS: Fecal immunochemical tests (FITs) are used widely in @entity14 screening. Programs use the same fecal hemoglobin threshold for colonoscopy referral for @entity1 and @entity1 , but it is unclear whether FIT performs equally in both sexes. We therefore assessed FIT performance in @entity1 and @entity1 . METHODS: A prospective cohort study was performed, in which a total of 10,008 average-risk subjects (age, 50-74 y) were invited for first-round screening and 8316 average-risk subjects (age, 51-74 y) were invited for second-round screening with a single FIT. Subjects with a hemoglobin (Hb) level of 10  g hemoglobin (Hb)/g (or >= 50 ng/mL) feces or higher were referred for colonoscopy. The test characteristics were assessed by sex for a range of FIT cut-off values. RESULTS: In total, 59.8% of @entity1 and 64.6% of @entity1 participated in the first round (P < .001). At a cut-off level of 10  g Hb/g, the positivity rate was significantly higher among @entity1 (10.7%) compared with @entity1 (6.3%; P < .001) in the first round. The detection rate of advanced @entity5 was 4.4% for @entity1 and 2.2% for @entity1 (P < .001) in the first round. The positive predictive value for advanced @entity5 in the first round was 42% for @entity1 and 37% for @entity1 (P  = .265). A significantly higher false-positive rate in @entity1 (6.3%) than in @entity1 (4.1%; P < .001) was found. Similar differences in these test characteristics were seen in the second round. CONCLUSIONS: At a cut-off level of 10  g Hb/g the FIT positivity rate was higher in @entity1 , reflected by both a higher detection rate and a higher false-positive rate. The use of the same cut-off value in @entity1 and @entity1 in FIT screening is recommended based on equal test performance in terms of positive predictive value.
