Questionnaire as a stratification method in organizing colorectal cancer screening

Abstract

The purpose of the study: to compare the efficacy of questionnaires and fecal immunochemical tests in stratification of risk groups during colorectal cancer screening. A non-randomized comparative study was conducted to evaluate the effectiveness of two stratification methods for colorectal cancer screening as part of pilot projects in the regions of the Central Federal District of the Russian Federation. In the first group, the stratification method was the original questionnaire, and in the second group — the fecal immunochemical test (FIT). All participants included in the first and second groups underwent colonoscopy at the second stage of screening. A total of 250 respondents participated in the study, 128 in the questionnaire group and 122 in the FIT group. In the questionnaire group, a high risk of colorectal cancer was found in 91 (71.1 %) individuals, while 37 (28.9 %) respondents had a low risk. Based on colonoscopy results, colorectal cancer and colorectal polyps were diagnosed in 65 (50.8 %) participants, and no significant pathology was found in 63 (49.2 %). In the FIT group, 102 (83.6 %) participants tested positive (FIT+) and 20 (16.4 %) tested negative (FIT-). According to the results of the performed colonoscopy, colorectal cancer and colon polyps were diagnosed in 75 (61.5 %) individuals, while no significant pathology was detected in 47 (38.5 %) participants. The sensitivity of the questionnaire was 86.2 % (95 % CI 75.3–93.5 %) and specificity was 44.4 % (95 % CI 31.9–57.5 %); the predictive value of a positive result was 61.5 % (95 % CI 50.7–71.6 %), and the predictive value of a negative result was 75.7 % (95 % CI 58.8–88.2 %). The FIT sensitivity was 86.7 % (95 % CI 76.8–93.4 %), the specificity was 21.3 % (95 % CI 10.7–35.7 %), the predictive value of a positive result was 63.7 % (95 % CI 53.6–73.0 %), and the predictive value of a negative result was 50.0 % (95 % CI 27.2–72.8 %). In conclusion, the questionnaire method in the colorectal cancer screening model is comparable in sensitivity and specificity to those of the FIT. It is essential to emphasize that questionnaires, along with ease of implementation, do not entail significant economic costs.