Hiroki Endo1, Takayuki Kato2, Eiji Sakai2, Leo Taniguchi3, Jun Arimoto4, Harunobu Kawamura5, Takuma Higurashi2, Hidenori Ohkubo2, Takashi Nonaka2, Masataka Taguri6, Masahiko Inamori2, Takeharu Yamanaka6, Takashi Sakaguchi4, Yasuo Hata3, Hajime Nagase7, Atsushi Nakajima2. 1. Division of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. endo1978@yokohama-cu.ac.jp. 2. Division of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 3. Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan. 4. Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan. 5. Department of Gastroenterology, Odawara Municipal Hospital, Odawara, Japan. 6. Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 7. Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan.
Abstract
BACKGROUND: Aspirin use is reportedly not to be associated with fecal immunochemical occult blood test (FIT) false-positive results for the detection of colorectal cancer. The need for additional small bowel exploration in FIT-positive, low-dose aspirin users with a negative colonoscopy is controversial. The aim of this study was to assess the ability of FIT to judge whether capsule endoscopy (CE) should be performed in low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy findings by comparing FIT results with CE findings. METHODS: A total of 264 consecutive low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy who were scheduled to undergo CE at five hospitals in Japan were enrolled. Patients had been offered FIT prior to the CE. The association between the FIT results and the CE findings was then assessed. RESULTS: One hundred and fifty-seven patients were included in the final analysis. Eighty-four patients (53.5 %) had positive FIT results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of positive FIT results for small bowel ulcers were 0.56, 0.47, 0.30, and 0.73, respectively. Furthermore, the NPV of positive FIT results for severe small bowel injury (Lewis score ≥790) was markedly high (0.90). When the analysis was performed only in low-dose aspirin users with anemia, the sensitivity of the positive FIT results was notably improved (0.72). CONCLUSIONS: Small bowel evaluation using CE is not recommended for FIT-negative, low-dose aspirin users. However, small bowel evaluation using CE should be considered in both FIT-positive and anemic low-dose aspirin users.
BACKGROUND:Aspirin use is reportedly not to be associated with fecal immunochemical occult blood test (FIT) false-positive results for the detection of colorectal cancer. The need for additional small bowel exploration in FIT-positive, low-dose aspirin users with a negative colonoscopy is controversial. The aim of this study was to assess the ability of FIT to judge whether capsule endoscopy (CE) should be performed in low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy findings by comparing FIT results with CE findings. METHODS: A total of 264 consecutive low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy who were scheduled to undergo CE at five hospitals in Japan were enrolled. Patients had been offered FIT prior to the CE. The association between the FIT results and the CE findings was then assessed. RESULTS: One hundred and fifty-seven patients were included in the final analysis. Eighty-four patients (53.5 %) had positive FIT results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of positive FIT results for small bowel ulcers were 0.56, 0.47, 0.30, and 0.73, respectively. Furthermore, the NPV of positive FIT results for severe small bowel injury (Lewis score ≥790) was markedly high (0.90). When the analysis was performed only in low-dose aspirin users with anemia, the sensitivity of the positive FIT results was notably improved (0.72). CONCLUSIONS: Small bowel evaluation using CE is not recommended for FIT-negative, low-dose aspirin users. However, small bowel evaluation using CE should be considered in both FIT-positive and anemic low-dose aspirin users.
Authors: Zohar Levi; Paul Rozen; Rachel Hazazi; Alex Vilkin; Amal Waked; Eran Maoz; Shlomo Birkenfeld; Moshe Leshno; Yaron Niv Journal: Ann Intern Med Date: 2007-02-20 Impact factor: 25.391
Authors: B C-Y Wong; W M Wong; K L Cheung; T S M Tong; P Rozen; G P Young; K W Chu; J Ho; W L Law; H M Tung; K C Lai; W H C Hu; C K Chan; S K Lam Journal: Aliment Pharmacol Ther Date: 2003-11-01 Impact factor: 8.171