PhD defence E. (Els) Wieten


Prof.dr. M.J. Bruno


Dr. V.M.C.W. Spaander

Wednesday 18 Dec 2019, 09:30 - 11:00
PhD defence
Professor Andries Querido room
Education Center
Erasmus MC
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On Wednesday 18 December 2019, E. Wieten will defend her PhD dissertation, entitled: ‘FIT for Colorectal Cancer Screening: From standard to tailored strategies’.

The aims of this thesis are to compare different fecal occult blood tests for colorectal cancer (CRC) screening and to explore tailored fecal immunochemical test (FIT)-based screening strategies. We performed a systematic literature search and meta-analysis to determine the pooled incidence rates of interval cancers following a negative guaiac fecal occult blood test (gFOBT) and FIT in Chapter 2. In this chapter, we also assessed how these two types of tests compare with regard to interval cancer incidence. In Chapter 3, we assess the accuracy of two FIT assays in detecting advanced neoplasia in the Dutch CRC screening program. To facilitate further informed decision-making on implementing one of both tests for a CRC screening program, we assessed participation rates and ease of use of the tests in Chapter 4. Furthermore, we compare the accuracy of the two FIT assays in detecting advanced neoplasia across various test positivity cut-offs in Chapter 5. Second, we explore tailored CRC screening strategies with FIT. Potential factors of use for tailored or personalized screening may include sex, age, family history, genetic and environmental factors, lifestyle, fecal hemoglobin levels detected (over time) and multiple sample screening. In Chapter 6, we assess the diagnostic yield of two-sample screening and provide information for the decision-making on how to deal with two discordant FIT results. We further analyze positivity rates and detection rates of advanced neoplasia across age categories in Chapter 7, and assess how these relate to the positive predictive values and colonoscopy demand at multiple test positivity cut-offs.  Finally, we illustrate the effect of gender-tailored FIT screening in Chapter 8.

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 09.30 hrs. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.

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