UNIVERSITY OF CALGARY Community Fecal Immunotesting for Colorectal Cancer Screening by

UNIVERSITY OF CALGARY
Community Fecal Immunotesting for Colorectal Cancer Screening
by
Amber Lynn Crouse
A THESIS
SUBMITTED TO THE FACULTY OF GRADUATE STUDIES
IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTERS OF SCIENCES
MEDICAL SCIENCE GRADUATE PROGRAM
CALGARY, ALBERTA
March, 2015
© Amber Lynn Crouse 2015

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Abstract
Community fecal immunochemical testing screening programs are important for
detecting early disease and are a common way of promoting colorectal cancer screening
by primary care physicians.
Fecal Immunochemical testing has advantages to the patient as well as to clinical
laboratories, but screening rates remain low across Canada and may be associated with
sociodemographic factors.
This research assesses the operational test characteristics of a FIT pilot program
in Calgary, Alberta. Data from a new community-based screening program were also
used to test associations of screening rate with sociodemographic variables.
The performance of FIT in this clinical setting was very good for detecting
carcinoma, but marginal for detection of colonic adenomas. There was also significant
geographic variation in screening rates in Calgary. These are associated with a number
of sociodemographic factors.

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Preface
This preface lists the publications by the author of this thesis which include the materials
and ideas presented in the thesis.
1. Crouse, A., et al., Sociodemographic correlates of fecal immunotesting for
colorectal cancer screening. Clin Biochem, 2015. 48(3): p. 105-9.
2. Crouse A, de Koning L, Sadrzadeh H, Naugler C. Sensitivity and specificity of
community fecal immumotesting screening for colorectal carcinoma in a high risk
Canadian population. Archives of Pathology and Laboratory Medicine, 2015.
3. Crouse A, de Koning L, Sadrzadeh H, Naugler C. Test characteristic of
community fecal immunotesting for colorectal carcinoma in Calgary, Alberta.
Poster presentation, CAP-ACP Conference, 13 July 2014.
4. Crouse A, Sadrzadeh H, de Koning L, Naugler C. Sociodemographic factors
affecting fecal immunotesting for colorectal cancer screening. Poster
presentation, University of Pathology, Department of Pathology and Laboratory
Medicine Annual Residents’ & Graduate Students’ Research Day, 07 November
2014.

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Acknowledgements
I would like to extend sincere thank you and gratitude to a few individuals for all
of their effort, and for generously giving their time and knowledge to assist me in this
program.
I would like to thank my program director, Dr. Amy Bromley and medical
director, Dr. Jim Wright for giving me the opportunity to be a part of the PA program and
for their help along the way.
I would like to express my appreciation and many thanks to my advisor, Dr.
Christopher Naugler for his endless guidance and advice, without whom I would not have
made it though this research. I would also like to thank my committee members, Dr.
Hossein Sadrzadeh and Dr. Lawrence De Koning for their knowledge advice through the
writing process.
To Jeannine Viczko who acquired the data from the Calgary Laboratory Services
LIS and Maggie Guo who helped with the statistical analysis and geomapping the data
with the use of the ArcGIS software and hot spot analysis, thank you.
Finally to my classmates, Calgary Lab Services, and IWK Health Centre for
providing me with the skills, knowledge, and endless resources.

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Dedication
To mom and dad, thank you for your endless encouragement and support. I would not be
where I am today without you.
To my brother, thank you for raising the bar high and making me constantly strive
towards achieving my goals.