Type

Journal Article

Authors

Deirdre McNamara
Colm O'Morain
Grainne Holleran
Chun Seng-Lee
Ronan Leen

Subjects

Medicine & Nursing

Topics
feasibility studies predictive value of tests humans colorectal neoplasms feces pyruvate kinase thyroid hormone binding proteins female chemistry thyroid hormones pilot projects enzymology neoplasm staging pathology colonoscopy male membrane proteins middle aged aged tumor markers biological patient acceptance of health care adenoma immunohistochemistry carrier proteins early detection of cancer

Comparison of faecal M2-PK and FIT in a population-based bowel cancer screening cohort. (2014)

Abstract Screening for colorectal cancer improves outcomes and is cost effective. Stool-based tests have the highest participation rates in screening programmes. Their efficacy is limited by the relatively low sensitivity and specificity compared with colonoscopy. Stool levels of M2-PK, a dimeric form of the enzyme pyruvate kinase, correlate with colorectal cancer and neoplasia. A combination of stool markers may enhance screening performance; however, it remains to be determined whether an additional test would affect participation rates negatively. The aim of this study was to assess the performance of faecal M2-PK and faecal immunochemical test (FIT) and their combined effect in a screening programme. Within round 2 of our biennial FIT-based pilot, all invitations additionally included an M2-PK kit. A FIT greater than 100 ngHb/ml and/or an M2-PK greater than 4 U/ml were considered positive. FIT-positive or M2-PK-positive patients were offered a colonoscopy. In all, 1800 combined M2-PK and FIT invites were sent out, and 879 (49%) samples were analysed. Overall positivity was 27% (n=245). Only 23 (2.6%) patients were positive for both tests. In all, 186 (88%) screening colonoscopies were performed. The adenoma detection rate for M2-PK-positive patients (n=157) was significant at 25% (n=40), and 3% (n=5) had advanced lesions. In FIT-positive patients (n=51), the adenoma detection rate was 29% (n=15), with significantly more, 21% (n=11), having advanced lesions (P<0.001, confidence interval 0.117-0.156). Had FIT only been tested, 70% (n=35) fewer patients would have had polyps removed. The addition of M2-PK in a biennial bowel screening programme is acceptable to patients, feasible and detects additional adenomas, potentially at an earlier stage.
Collections Ireland -> TU Dublin (Tallaght Campus) -> PubMed

Full list of authors on original publication

Deirdre McNamara, Colm O'Morain, Grainne Holleran, Chun Seng-Lee, Ronan Leen

Experts in our system

1
Deirdre McNamara
TU Dublin (Tallaght Campus)
Total Publications: 51
 
2
Colm O'Morain
TU Dublin (Tallaght Campus)
Total Publications: 82
 
3
Grainne Holleran
TU Dublin (Tallaght Campus)
Total Publications: 18