BACKGROUND: The guaiac faecal occult blood test (G-FOBT), HemoccultSENSA, is sensitive for significant neoplasms [colorectal cancer (CRC), advanced adenomatous polyps (AAP)], but faulted by non-specificity for human haemoglobin (Hb). Quantified, Hb- specific, immunochemical faecal occult blood tests (I-FOBT) are now used. AIMS: To (i) compare I-FOBT and G-FOBT efficacy in identifying significant neoplasms and colonoscopy needs for positive tests and (ii) examine number of I-FOBTs needed and test threshold to use for equivalent or better sensitivity than G-FOBT and fewest colonoscopies for positive tests. METHODS: Three daily G-FOBTs and I-FOBTs were collected and analysed in 330 patients scheduled for colonoscopy. RESULTS: Colonoscopy found significant neoplasms in 32 patients, 6 CRC, 26 AAP. G-FOBT, sensitivity and specificity were 53.1% (17 neoplasms) and 59.4%, resulting in 8.1 colonoscopies/neoplasm. One I-FOBT having >or=50 ngHb/mL of buffer provided equivalent sensitivity but 94.0% specificity, resulting in 2.1 colonoscopies/neoplasm. By analysing the higher of two I-FOBTs at 50 ngHb/mL threshold, sensitivity increased to 68.8% (22 neoplasms, P = 0.063), specificity fell to 91.9% (P < 0.001), but still required 2.1 colonoscopies/neoplasm. CONCLUSIONS: In this population, quantified I-FOBT had significantly better specificity than G-FOBT for significant neoplasms, reducing the number of colonoscopies needed/neoplasm detected. Results depend on the number of I-FOBTs performed and the chosen development threshold.
BACKGROUND: The guaiac faecal occult blood test (G-FOBT), HemoccultSENSA, is sensitive for significant neoplasms [colorectal cancer (CRC), advanced adenomatous polyps (AAP)], but faulted by non-specificity for human haemoglobin (Hb). Quantified, Hb- specific, immunochemical faecal occult blood tests (I-FOBT) are now used. AIMS: To (i) compare I-FOBT and G-FOBT efficacy in identifying significant neoplasms and colonoscopy needs for positive tests and (ii) examine number of I-FOBTs needed and test threshold to use for equivalent or better sensitivity than G-FOBT and fewest colonoscopies for positive tests. METHODS: Three daily G-FOBTs and I-FOBTs were collected and analysed in 330 patients scheduled for colonoscopy. RESULTS: Colonoscopy found significant neoplasms in 32 patients, 6 CRC, 26 AAP. G-FOBT, sensitivity and specificity were 53.1% (17 neoplasms) and 59.4%, resulting in 8.1 colonoscopies/neoplasm. One I-FOBT having >or=50 ngHb/mL of buffer provided equivalent sensitivity but 94.0% specificity, resulting in 2.1 colonoscopies/neoplasm. By analysing the higher of two I-FOBTs at 50 ngHb/mL threshold, sensitivity increased to 68.8% (22 neoplasms, P = 0.063), specificity fell to 91.9% (P < 0.001), but still required 2.1 colonoscopies/neoplasm. CONCLUSIONS: In this population, quantified I-FOBT had significantly better specificity than G-FOBT for significant neoplasms, reducing the number of colonoscopies needed/neoplasm detected. Results depend on the number of I-FOBTs performed and the chosen development threshold.
Authors: Vicent Hernandez; Joaquin Cubiella; M Carmen Gonzalez-Mao; Felipe Iglesias; Concepción Rivera; M Begoña Iglesias; Lucía Cid; Ines Castro; Luisa de Castro; Pablo Vega; Jose Antonio Hermo; Ramiro Macenlle; Alfonso Martínez-Turnes; David Martínez-Ares; Pamela Estevez; Estela Cid; M Carmen Vidal; Angeles López-Martínez; Elisabeth Hijona; Marta Herreros-Villanueva; Luis Bujanda; Jose Ignacio Rodriguez-Prada Journal: World J Gastroenterol Date: 2014-01-28 Impact factor: 5.742
Authors: K L Flitcroft; D J B St John; K Howard; S M Carter; M P Pignone; G P Salkeld; L J Trevena Journal: J Med Screen Date: 2011-11-21 Impact factor: 2.136
Authors: Monika Ferlitsch; Georg Heinze; Petra Salzl; Martha Britto-Arias; Elisabeth Waldmann; Karoline Reinhart; Christina Bannert; Elisabeth Fasching; Peter Knoflach; Werner Weiss; Michael Trauner; Arnulf Ferlitsch Journal: Med Oncol Date: 2014-08-14 Impact factor: 3.064
Authors: Joaquín Cubiella; Inés Castro; Vicent Hernandez; Carmen González-Mao; Concepción Rivera; Felipe Iglesias; María Teresa Alves; Lucía Cid; Santiago Soto; Luisa De-Castro; Pablo Vega; Jose Antonio Hermo; Ramiro Macenlle; Alfonso Martínez; Pamela Estevez; Estela Cid; Marta Herreros-Villanueva; Isabel Portillo; Luis Bujanda; Javier Fernández-Seara Journal: United European Gastroenterol J Date: 2014-12 Impact factor: 4.623
Authors: Kathy L Flitcroft; Les M Irwig; Stacy M Carter; Glenn P Salkeld; James A Gillespie Journal: BMC Gastroenterol Date: 2012-12-29 Impact factor: 3.067