Ambient temperature and FIT performance in the Emilia-Romagna colorectal cancer screening programme

Gianfranco De Girolamo, Carlo Alberto Goldoni, Rossella Corradini, Orietta Giuliani, Fabio Falcini, Priscilla Sassoli De’Bianchi, Carlo Naldoni, Stefano Zauli Sajani

Research output: Contribution to journalArticlepeer-review


Objective: To assess the impact of ambient temperature on faecal immunochemical test (FIT) performance in the colorectal cancer screening programme of Emilia-Romagna (Italy). Methods: A population-based retrospective cohort study on data from 2005 to 2011. Positive rate, detection rate, and positive predictive value rate for cancers and adenomas, and incidence rate of interval cancers after negative tests were analysed using Poisson regression models. In addition to ambient temperature, gender, age, screening history, and Local Health Unit were also considered. Results: In 1,521,819 tests analysed, the probability of a positive result decreased linearly with increasing temperature. Point estimates and 95% Confidence Intervals were estimated for six temperature classes (<5, 5 |-10, 10 |-15, 15 |-20, 20|-25 and ≥25°C), and referred to the 5|-10°C class. The positive rate ratio was significantly related to temperature increase: 0.99 (0.97-1.02), 1, 0.98 (0.96-1.00), 0.96 (0.94-0.99), 0.93 (0.91-0.96), 0.92 (0.89-0.95). A linear trend was also evident for advanced adenoma detection rate ratio: 1.00 (0.96-1.04), 1, 0.98 (0.93-1.02), 0.96 (0.92-1.00), 0.92 (0.88-0.96), 0.94 (0.88-1.01). The effect was less linear, but still important, for cancer detection rates: 0.95 (0.85-1.06), 1, 1.00 (0.90-1.10), 0.94 (0.85-1.05), 0.81 (0.72-0.92), 0.93 (0.80-1.09). No association or linear trend was found for positive predictive values or risk of interval cancer, despite an excess of +16% in the highest temperature class for interval cancer. Conclusions: Ambient temperatures can affect screening performance. Continued monitoring is needed to verify the effect of introducing FIT tubes with a new buffer, which should guarantee a higher stability of haemoglobin.

Original languageEnglish
Pages (from-to)186-191
Number of pages6
JournalJournal of Medical Screening
Issue number4
Publication statusPublished - 2016


  • Colorectal cancer screening
  • Faecal immunochemical test
  • Interval cancer
  • Occult blood
  • Temperature

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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