1.Analysis of factors associated with false-positive results and optimal positivity thresholds of quantitative fecal immunochemical test in colorectal cancer screening
Yi ZHOU ; Weimiao WU ; Chen ZHU ; Tingting PAN ; Jinjin HE ; Lüe HONG ; Bin LIU ; Le WANG ; Lingbin DU
Chinese Journal of Preventive Medicine 2025;59(10):1691-1702
Objective:To analyze risk factors associated with false-positive results of quantitative fecal immunochemical testing (FIT), evaluate its performance for detecting advanced colorectal neoplasia across different subgroups, and explore the optimal positivity thresholds for each subgroup.Methods:Individuals who participated in the Zhejiang Colorectal Cancer Screening Program in 2020-2021, completed questionnaire-based risk assessment and quantitative FIT for initial screening, and undertook colonoscopy for confirmed diagnosis were included in this study. The information of individuals, including demographic characteristics, lifestyles, history of diseases, and family history of colorectal cancer (CRC), was collected by using questionnaires. The diagnostic outcomes of the individuals were obtained through colonoscopy and pathological examination. Multivariate logistic regression analyses were conducted to identify factors associated with false-positive FIT results. The optimal threshold of FIT was determined based on the receiver operating characteristic (ROC) curve and 10-fold cross-validation. The effectiveness of FIT screening in different subgroups was compared using the unified threshold of 100 ng/ml or optimal positivity thresholds.Results:There were 25 874 individuals included in the analysis, with 14 694 (56.79%) having fecal hemoglobin concentrations ≥100 ng/ml. A total of 3 830 advanced adenoma cases (14.80%) and 362 CRC cases (1.40%) were identified. Age below 60 years old, females, underweight, smoking, drinking, use of nonsteroidal anti-inflammatory drugs, no family history of CRC, no history of intestinal disease, no history of hypertension, and physical inactivity were associated with an elevated risk of false-positive results in FIT ( P<0.05). Compared to the predetermined threshold of 100 ng/ml, the false positive rate (FPR) of quantitative FIT decreased from 52.3% to 37.3% in all individuals, and decreased by more than 20% in females, individuals with normal weight, smokers, and those without a history of intestinal disease when adopting the optimal threshold (all P<0.001). Conclusion:The risk of false-positive results in quantitative FIT varies across different subgroups. Adopting the optimal thresholds could improve the specificity and reduce the FPR of quantitative FIT for CRC screening.
2.Analysis of factors associated with false-positive results and optimal positivity thresholds of quantitative fecal immunochemical test in colorectal cancer screening
Yi ZHOU ; Weimiao WU ; Chen ZHU ; Tingting PAN ; Jinjin HE ; Lüe HONG ; Bin LIU ; Le WANG ; Lingbin DU
Chinese Journal of Preventive Medicine 2025;59(10):1691-1702
Objective:To analyze risk factors associated with false-positive results of quantitative fecal immunochemical testing (FIT), evaluate its performance for detecting advanced colorectal neoplasia across different subgroups, and explore the optimal positivity thresholds for each subgroup.Methods:Individuals who participated in the Zhejiang Colorectal Cancer Screening Program in 2020-2021, completed questionnaire-based risk assessment and quantitative FIT for initial screening, and undertook colonoscopy for confirmed diagnosis were included in this study. The information of individuals, including demographic characteristics, lifestyles, history of diseases, and family history of colorectal cancer (CRC), was collected by using questionnaires. The diagnostic outcomes of the individuals were obtained through colonoscopy and pathological examination. Multivariate logistic regression analyses were conducted to identify factors associated with false-positive FIT results. The optimal threshold of FIT was determined based on the receiver operating characteristic (ROC) curve and 10-fold cross-validation. The effectiveness of FIT screening in different subgroups was compared using the unified threshold of 100 ng/ml or optimal positivity thresholds.Results:There were 25 874 individuals included in the analysis, with 14 694 (56.79%) having fecal hemoglobin concentrations ≥100 ng/ml. A total of 3 830 advanced adenoma cases (14.80%) and 362 CRC cases (1.40%) were identified. Age below 60 years old, females, underweight, smoking, drinking, use of nonsteroidal anti-inflammatory drugs, no family history of CRC, no history of intestinal disease, no history of hypertension, and physical inactivity were associated with an elevated risk of false-positive results in FIT ( P<0.05). Compared to the predetermined threshold of 100 ng/ml, the false positive rate (FPR) of quantitative FIT decreased from 52.3% to 37.3% in all individuals, and decreased by more than 20% in females, individuals with normal weight, smokers, and those without a history of intestinal disease when adopting the optimal threshold (all P<0.001). Conclusion:The risk of false-positive results in quantitative FIT varies across different subgroups. Adopting the optimal thresholds could improve the specificity and reduce the FPR of quantitative FIT for CRC screening.
4.The reasons of fighter aircraft high +Gz induced pilot's neck injuries and prevention
Lüe DENG ; Zhao JIN ; Xi-chen GENG ; Li-hui ZHANG ; Hong WANG ; Hai-xia WANG ; Yi-feng LI ; Quan WANG
Chinese Journal of Aerospace Medicine 2010;21(4):310-314
Objective To review the reasons, mechanism of fighter aircraft high +Gz induced pilot's neck injuries and prevention methods, and to expect the integrative methods for enhancing prevention effects.Literature resource and selection Professional references which were published at home and abroad were cited.Literature quotation Fifty published papers and reviews were referred.Literature synthesis The characters of modern high-performance fighter aircraft which was described as high +Gz and the rapid onset rate acceleration induced serious harm to pilot's neck.Since more than 20 years, many researches on mechanism and the reasons of inducing neck injuries had conducted by scholars.They indicated the consensus in the factors of inducing neck injuries, including +Gz threshold, the load on pilot's head, passive effect on back seat, unsuitable head posture in flight and frequent exposure in high +Gz.The preventions were primarily focused on leaning upon cervical spine function evaluation and neck muscle strength training, developing protective equipment and improving man-machine adaptability of equipment.Conclusions In fighter pilot's career, it is unavoidable that he will be threatened by high +Gz environment.At present, it is important to adopt integrative preventions and emphasize effective research for increasing pilot's capability for adapting high + Gz environment and protecting himself.Also such experience will be useful in preventing pilot's waist injuries induced by high +Gz.
5.The reasons of fighter aircraft high +Gz induced pilot's neck injuries and prevention
Lüe DENG ; Zhao JIN ; Xi-chen GENG ; Li-hui ZHANG ; Hong WANG ; Hai-xia WANG ; Yi-feng LI ; Quan WANG
Chinese Journal of Aerospace Medicine 2010;21(4):310-314
Objective To review the reasons, mechanism of fighter aircraft high +Gz induced pilot's neck injuries and prevention methods, and to expect the integrative methods for enhancing prevention effects.Literature resource and selection Professional references which were published at home and abroad were cited.Literature quotation Fifty published papers and reviews were referred.Literature synthesis The characters of modern high-performance fighter aircraft which was described as high +Gz and the rapid onset rate acceleration induced serious harm to pilot's neck.Since more than 20 years, many researches on mechanism and the reasons of inducing neck injuries had conducted by scholars.They indicated the consensus in the factors of inducing neck injuries, including +Gz threshold, the load on pilot's head, passive effect on back seat, unsuitable head posture in flight and frequent exposure in high +Gz.The preventions were primarily focused on leaning upon cervical spine function evaluation and neck muscle strength training, developing protective equipment and improving man-machine adaptability of equipment.Conclusions In fighter pilot's career, it is unavoidable that he will be threatened by high +Gz environment.At present, it is important to adopt integrative preventions and emphasize effective research for increasing pilot's capability for adapting high + Gz environment and protecting himself.Also such experience will be useful in preventing pilot's waist injuries induced by high +Gz.

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