Korean J Gastroenterol.  1997 Sep;30(3):308-314.

Compatison of Fecal Occult Blood Tests for Screening of Colorectal Neoplasia

Abstract

BACKGROUND AND AIMS: The guaiac test, the most available test for colorectal cancer screening, has low sensitivity for detecting colorectal cancer. Recently, some studies suggested that immunochemical fecal occult blood tests (FOBT) are more efficient at detecting colorectal cancer than the guaiac test. We compared the sensitivity and specificity of FOBTs in sympi,'omatic patients with total colonos-copy to determine whether a guaiac test or immunochemial test has superior efficiency for colorectal cancer screening.
METHODS
Hemoccult II"" (Smithklein Dia,mostics) and OC-Hemodia (Eiken chemical co.) was performed or 356 symptomatic patients in whom total colonoscopy was indicated. All patients underwent total colonoscopy after FOBT.
RESULTS
Co)orectal cancers were detected in 19 patients and polyps with diameter over 1cm were detected in 18 patients. The sensitivity of the test for detecting colorectal cancer was 42.11% in both of the tests, The specificity for colorectal cancer was 92.47% (95% confidence interval: 91.0 to 94.0%) with OC-Hemodia"" and 88.21% (95% CI:86.4 to 90.0%) with Hemoccult II . The sensitivity of both FOBT was 20% for ascending colon cancer, 0% for transverse colon cancer, 25.% for descending colon cancer, and 57.14% for rectosigmoid colon cancer. The sensitivity for polyps was 5.56% with OC-Hemodia"" and 5.88% with Hemoccult II"". The specificity for polyps wais 90.10% with OC-Hemodia' and 92.37% with Hemoccult II.
CONCLUSIONS
OC-Hemodia"" has no superiority to Hemoccult II for detecting colorectal cancer and both of the tests were by far not a an ideal screening test for colorectal cancer. The evaluation of the effect of FOBT for early diagnosis and reducing mortality in colorectal cancer as a mass screening test should be performed.

Keyword

Fecal occult blood test; Colon cancer screening

MeSH Terms

Colon, Ascending
Colon, Descending
Colon, Transverse
Colonic Neoplasms
Colonoscopy
Colorectal Neoplasms
Early Diagnosis
Guaiac
Humans
Mass Screening*
Mortality
Occult Blood*
Polyps
Sensitivity and Specificity
Guaiac
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