Colorectal Cancer Screening in Average Risk Populations: Evidence Summary

Table 4

GRADE evidence profile—gFOBT versus FIT.

Quality assessment

Number of patients

Effect

Quality

Importance

Number of studies

Design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

FIT

gFOBT

Relative (95% CI)

Absolute

Complications from tests

1

Randomized trial

Not serious

Not serious

Not serious

Serious^1

Not serious

Not pooled

⨁⨁⨁◯; Moderate

Critical

CRC/advanced adenoma detection rate (ITS)

5

Randomized trials

Not serious

Not serious

Serious^2

Not serious

Not serious

278/24,288 (1.1%)

129/27,346 (0.5%)

RR 2.15 (1.58–2.94)

5 more per 1000 (from 3 more to 9 more)

⨁⨁⨁◯; Moderate

Important

CRC/advanced adenoma detection rate (PP)

5

Randomized trials

Not serious

Not serious

Serious^2

Not serious

Not serious

278/12,146 (2.3%)

129/10,976 (1.2%)

RR 1.83 (1.30–2.57)

10 more per 1000 (from 4 more to 18 more)

⨁⨁⨁◯; Moderate

Important

False-positive screening test results

5

Randomized trials

Not serious

Serious^3

Not serious

Not serious

Not serious

385/24,288 (1.6%)

188/27,346 (0.7%)

RR 2.12 (1.02–4.39)

8 more per 1000 (from 0 fewer to 23 more)

⨁⨁⨁◯; Moderate

Important

Participation rate

6

Randomized trials

Not serious

Serious^4

Not serious

Not serious

Not serious

12,271/24,490 (50.1%)

11075/27,548 (40.2%)

RR 1.16 (1.05–1.28)

64 more per 1000 (from 20 more to 113 more)

⨁⨁⨁◯; Moderate

Important

CI: confidence interval; CRC: colorectal cancer; FIT: fecal immunochemical test; gFOBT: guaiac fecal occult blood test; GRADE: Grading of Recommendations, Assessment, Development and Evaluations; ITS: intention to screen; PP: per protocol; RR: relative risk.
¹Only one study.
²Surrogate outcome for CRC mortality.
³Heterogeneity: Tau² = 0.61; Chi² = 56.96, df = 3 (); = 93%.
⁴Heterogeneity: Tau² = 0.01; Chi² = 107.18, df = 5 (); = 95%.