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Original article
Attendance and diagnostic yield of repeated two-sample faecal immunochemical test screening for colorectal cancer
  1. Atija Kapidzic1,
  2. Aafke H C van Roon1,
  3. Monique E van Leerdam1,
  4. Anneke J van Vuuren1,
  5. Marjolein van Ballegooijen2,
  6. Iris Lansdorp-Vogelaar2,
  7. Wolfert Spijker3,
  8. Kirsten Izelaar3,
  9. Lieke Hol1,
  10. Ernst J Kuipers1
  1. 1Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
  2. 2Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
  3. 3Regional Organization for Population Screening South-West Netherlands, Rotterdam, The Netherlands
  1. Correspondence to Atija Kapidzic, Department of Gastroenterology and Hepatology (room Hs-306), Erasmus University Medical Centre, ‘s Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; a.kapidzic{at}


Objective Limited data exist on attendance and additional yield of 2-sample faecal immunochemical testing (FIT) screening during multiple rounds. We therefore conducted a population-based colorectal cancer screening trial comparing attendance and yield of repeated 1-sample and 2-sample FIT screenings.

Design Two randomly selected groups of average-risk subjects aged 50–74 years were invited for two rounds of either 1-sample (n=5007) or 2-sample (n=3197) FIT (OC-sensor Micro) screening. The test was considered positive if at least one sample was positive (cut-off 50 ng/mL; 10 µg haemoglobin/g).

Results The cumulative attendance rate was similar for repeated 1-sample and 2-sample FIT screenings (1-sample FIT: 68.1%; 2-sample FIT: 67.1%, p=0.368). The positivity rate in the second round was lower for 1-sample FIT (6.2%, 95% CI 5.4% to 7.2%) than for 2-sample FIT (8.4%, 95% CI 7.1% to 9.8%, p=0.007), whereas the detection rate of advanced neoplasia (AN, 1-sample FIT: 1.9%, 95% CI 1.2% to 2.2%; 2-sample FIT: 1.7%, 95% CI 1.2% to 2.5%, p=0.861) and the positive predictive value (1-sample FIT: 32%, 95% CI 24% to 40%; 2-sample FIT: 21%, 95% CI 15% to 29%, p=0.075) did not differ. After two rounds of screening, the cumulative diagnostic yield of AN for 1-sample FIT was 29.3 per 1000 invitees, compared with 34.0 for 2-sample FIT (p=0.241).

Conclusions Using 2-sample FIT instead of 1-sample FIT does not result in a higher detection rate of AN in the second round of repeated FIT screening. Furthermore, both strategies lead to a similar yield of AN over two rounds. These findings imply that 1-sample FIT screening is preferred over 2-sample FIT screening.


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