BACKGROUND: Although the immunochemical fecal occult blood test (FOBT) is reportedly more sensitive to large adenomas or colorectal cancer (CRC) than the guaiac-based FOBT, the sensitivity of the immunochemical FOBT to small adenomas has scarcely been reported. Previous reports have indicated that the guaiac-based FOBT can detect small adenomas only by serendipity. OBJECTIVES: To investigate the sensitivity of immunochemical FOBT to small adenomas using a large-scale cohort. METHODS: We analyzed 21,805 consecutively enrolled asymptomatic persons who underwent colonoscopy and immunochemical FOBT. RESULTS: The sensitivity to adenomas </=9 mm was significantly higher than the false-positive rate as revealed by analysis of all eligible subjects (7.0%vs 4.5%, P < 0.001). In men, the sensitivity was superior to the false-positive rate and increased with age (<50 yr 6.1% and >60 yr 11.3%). On the other hand, the sensitivity in women was not significantly different from the false-positive rate in any generation (5.1%vs 4.7% for all eligible women, P= 0.72). CONCLUSIONS: Immunochemical FOBT detected a small percentage of small adenomas in men at a rate that is significantly higher than the false-positive rate. Studies comparing the guaiac and immunochemical FOBTs using the end point of CRC-related death are expected.
BACKGROUND: Although the immunochemical fecal occult blood test (FOBT) is reportedly more sensitive to large adenomas or colorectal cancer (CRC) than the guaiac-based FOBT, the sensitivity of the immunochemical FOBT to small adenomas has scarcely been reported. Previous reports have indicated that the guaiac-based FOBT can detect small adenomas only by serendipity. OBJECTIVES: To investigate the sensitivity of immunochemical FOBT to small adenomas using a large-scale cohort. METHODS: We analyzed 21,805 consecutively enrolled asymptomatic persons who underwent colonoscopy and immunochemical FOBT. RESULTS: The sensitivity to adenomas </=9 mm was significantly higher than the false-positive rate as revealed by analysis of all eligible subjects (7.0%vs 4.5%, P < 0.001). In men, the sensitivity was superior to the false-positive rate and increased with age (<50 yr 6.1% and >60 yr 11.3%). On the other hand, the sensitivity in women was not significantly different from the false-positive rate in any generation (5.1%vs 4.7% for all eligible women, P= 0.72). CONCLUSIONS: Immunochemical FOBT detected a small percentage of small adenomas in men at a rate that is significantly higher than the false-positive rate. Studies comparing the guaiac and immunochemical FOBTs using the end point of CRC-related death are expected.
Authors: M Alexander; J B Burch; S E Steck; C-F Chen; T G Hurley; P Cavicchia; N Shivappa; J Guess; H Zhang; S D Youngstedt; K E Creek; S Lloyd; K Jones; J R Hébert Journal: Int J Colorectal Dis Date: 2016-10-22 Impact factor: 2.571
Authors: Iris Lansdorp-Vogelaar; Karen M Kuntz; Amy B Knudsen; Janneke A Wilschut; Ann G Zauber; Marjolein van Ballegooijen Journal: Ann Intern Med Date: 2010-09-21 Impact factor: 25.391
Authors: Elizabeth G Liles; Nancy Perrin; Ana Gabriela Rosales; Adrianne C Feldstein; David H Smith; David M Mosen; Jennifer L Schneider Journal: Am J Manag Care Date: 2012-10 Impact factor: 2.229
Authors: Linda Sharp; Lesley Tilson; Sophie Whyte; Alan O Ceilleachair; Cathal Walsh; Cara Usher; Paul Tappenden; James Chilcott; Anthony Staines; Michael Barry; Harry Comber Journal: BMC Health Serv Res Date: 2013-03-19 Impact factor: 2.655