Literature DB >> 19293792

Sensitivity, but not specificity, of a quantitative immunochemical fecal occult blood test for neoplasia is slightly increased by the use of low-dose aspirin, NSAIDs, and anticoagulants.

Zohar Levi1, Paul Rozen, Rachel Hazazi, Alex Vilkin, Amal Waked, Eran Maoz, Shlomo Birkenfeld, Nicky Lieberman, Shmuel Klang, Yaron Niv.   

Abstract

OBJECTIVES: We evaluated the effect of the use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), and anticoagulants on the performance of immunochemical fecal occult blood test (I-FOBT).
METHODS: A prospective, cross-sectional study of 1,221 ambulatory patients having total colonoscopy after preparing three I-FOBTs. Information regarding the use of medications was collected from the health medical organization (HMO) database. I-FOBT was analyzed with the OC-MICRO instrument using both >or=75 and 100 ngHb/ml of buffer thresholds to determine positivity.
RESULTS: Colorectal cancer (CRC) was found in 17 and advanced adenomatous polyp (AAP) in 97 patients. A total of 212 patients were using aspirin/NSAIDS at the time of I-FOBT testing. Qualitative analysis for the detection of AAP/CRC reveals a trend for an increased sensitivity with aspirin/NSAIDS use. At the threshold 75 ng/ml for positivity, the sensitivity for the detection of AAP/CRC was 66.7% for aspirin/NSAIDS use vs. 51.2% for nondrug takers (P=0.20), and at the threshold of 100 ng/ml, the sensitivity was 66.7 vs. 46.5% (P=0.09). The specificity, however, was not affected by the use of aspirin/NSAIDS. At the threshold of 75 ng/ml for positivity, the specificity for the detection of AAP/CRC was 89.5% for aspirin/NSAIDS use vs. 91.2% for nondrug takers (P=0.47), and at the threshold of 100 ng/ml, the specificity was 92.17 vs. 93.0% (P=0.69). A total of 33 patients were using antithrombotics/coagulants at the time of I-FOBT testing. This group was small; however, it appears that their use was also associated with a trend for increased sensitivity and no change in specificity.
CONCLUSIONS: The use of aspirin/NSAIDS and anticoagulants was associated with a trend for increased sensitivity with no change in specificity for the detection of AAP/CRC. This study suggests that there is no need to stop these agents before I-FOBT testing.

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Year:  2009        PMID: 19293792     DOI: 10.1038/ajg.2009.14

Source DB:  PubMed          Journal:  Am J Gastroenterol        ISSN: 0002-9270            Impact factor:   10.864


  26 in total

1.  How should individuals with a false-positive fecal occult blood test for colorectal cancer be managed? A decision analysis.

Authors:  Ulrike Haug; Amy B Knudsen; Karen M Kuntz
Journal:  Int J Cancer       Date:  2012-03-29       Impact factor: 7.396

2.  Effect of a Single Aspirin Dose Prior to Fecal Immunochemical Testing on Test Sensitivity for Detecting Advanced Colorectal Neoplasms: A Randomized Clinical Trial.

Authors:  Hermann Brenner; Silvia Calderazzo; Thomas Seufferlein; Leopold Ludwig; Nektarios Dikopoulos; Jörg Mangold; Wolfgang Böck; Thomas Stolz; Thomas Eisenbach; Thomas Block; Annette Kopp-Schneider; David Czock; Kaja Tikk
Journal:  JAMA       Date:  2019-05-07       Impact factor: 56.272

3.  Performance of the immunochemical fecal occult blood test in predicting lesions in the lower gastrointestinal tract.

Authors:  Tsung-Hsien Chiang; Yi-Chia Lee; Chia-Hung Tu; Han-Mo Chiu; Ming-Shiang Wu
Journal:  CMAJ       Date:  2011-08-02       Impact factor: 8.262

4.  Small bowel evaluation in asymptomatic fecal immunochemical test-positive patients with a negative colonoscopy: is it necessary?

Authors:  Jae Jun Park; Jae Hee Cheon
Journal:  Dig Dis Sci       Date:  2011-10       Impact factor: 3.199

5.  Test performance of faecal occult blood testing for the detection of bowel cancer in people with chronic kidney disease (DETECT) protocol.

Authors:  Germaine Wong; Kirsten Howard; Jeremy R Chapman; Allison Tong; Michael J Bourke; Andrew Hayen; Petra Macaskill; Richard L Hope; Narelle Williams; Anh Kieu; Richard Allen; Steven Chadban; Carol Pollock; Angela Webster; Simon D Roger; Jonathan C Craig
Journal:  BMC Public Health       Date:  2011-06-29       Impact factor: 3.295

6.  Fecal immunochemical tests for colorectal cancer screening: a systematic review of accuracy and compliance.

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Journal:  CADTH Technol Overv       Date:  2010-09-01

7.  Prevalence of significant neoplasia in FOBT-positive patients on warfarin compared with those not on warfarin.

Authors:  Lulu Iles-Shih; Judy F Collins; Jennifer L Holub; David A Lieberman
Journal:  Am J Gastroenterol       Date:  2010-08-03       Impact factor: 10.864

Review 8.  Colorectal cancer screening--optimizing current strategies and new directions.

Authors:  Ernst J Kuipers; Thomas Rösch; Michael Bretthauer
Journal:  Nat Rev Clin Oncol       Date:  2013-02-05       Impact factor: 66.675

Review 9.  Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer.

Authors:  Douglas J Robertson; Jeffrey K Lee; C Richard Boland; Jason A Dominitz; Francis M Giardiello; David A Johnson; Tonya Kaltenbach; David Lieberman; Theodore R Levin; Douglas K Rex
Journal:  Am J Gastroenterol       Date:  2016-10-18       Impact factor: 10.864

10.  Nonsteroidal Anti-Inflammatory Drug-Induced Colopathy in a Colorectal Cancer Screening Program.

Authors:  Sanja Borozan; Ljiljana Vuckovic; Brigita Smolovic
Journal:  Med Princ Pract       Date:  2018-10-25       Impact factor: 1.927

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