Y Niv1, A D Sperber. 1. Department of Gastroenterology, Beilinson Medical Center, Petah-Tikva, Israel.
Abstract
OBJECTIVES: To evaluate the specificity, sensitivity, and positive predictive value of fecal occult blood testing (FOBT) in symptomatic patients, with colonoscopy as the gold standard, and to assess the usefulness of FOBT as an ancillary examination in symptomatic patients for whom total colonoscopy is indicated. METHODS: We studied 439 consecutive patients who underwent Hemoccult II testing before total colonoscopy. RESULTS: The sensitivity, specificity, and positive predictive value for colorectal neoplasia (cancer and adenomatous polyps) was 76.5%, 56.7%, and 27.6%, respectively. The sensitivity, specificity, and positive predictive value for colorectal cancer were 69.2%, 73.2%, and 7.3%, respectively. CONCLUSIONS: The sensitivity, specificity, and positive predictive value of FOBT are difficult to estimate from screening programs, because Hemoccult-negative individuals do not undergo examination of the colon, and many of the Hemoccult-positive cases do not undergo total colonoscopy. With total colonoscopy serving as the gold standard, FOBT does not appear to be of much value as an ancillary examination in patients with symptoms potentially attributable to the lower gastrointestinal tract.
OBJECTIVES: To evaluate the specificity, sensitivity, and positive predictive value of fecal occult blood testing (FOBT) in symptomatic patients, with colonoscopy as the gold standard, and to assess the usefulness of FOBT as an ancillary examination in symptomatic patients for whom total colonoscopy is indicated. METHODS: We studied 439 consecutive patients who underwent Hemoccult II testing before total colonoscopy. RESULTS: The sensitivity, specificity, and positive predictive value for colorectal neoplasia (cancer and adenomatous polyps) was 76.5%, 56.7%, and 27.6%, respectively. The sensitivity, specificity, and positive predictive value for colorectal cancer were 69.2%, 73.2%, and 7.3%, respectively. CONCLUSIONS: The sensitivity, specificity, and positive predictive value of FOBT are difficult to estimate from screening programs, because Hemoccult-negative individuals do not undergo examination of the colon, and many of the Hemoccult-positive cases do not undergo total colonoscopy. With total colonoscopy serving as the gold standard, FOBT does not appear to be of much value as an ancillary examination in patients with symptoms potentially attributable to the lower gastrointestinal tract.
Authors: W S A Smellie; K K Hampton; R Bowley; R Bowlees; S C Martin; N Shaw; J Hoffman; J P Ng; S M Mackenzie; C van Heyningen Journal: J Clin Pathol Date: 2006-12-15 Impact factor: 3.411
Authors: Sandeep Vijan; Inku Hwang; John Inadomi; Roy K H Wong; J Richard Choi; John Napierkowski; Jonathan M Koff; Perry J Pickhardt Journal: Am J Gastroenterol Date: 2006-12-11 Impact factor: 10.864
Authors: Petra Jellema; Daniëlle A W M van der Windt; David J Bruinvels; Christian D Mallen; Stijn J B van Weyenberg; Chris J Mulder; Henrica C W de Vet Journal: BMJ Date: 2010-03-31
Authors: Mallikarjuna Uppara; Franklin Adaba; Alan Askari; Susan Clark; George Hanna; Thanos Athanasiou; Omar Faiz Journal: World J Surg Oncol Date: 2015-02-13 Impact factor: 2.754
Authors: Marie Westwood; Shona Lang; Nigel Armstrong; Sietze van Turenhout; Joaquín Cubiella; Lisa Stirk; Isaac Corro Ramos; Marianne Luyendijk; Remziye Zaim; Jos Kleijnen; Callum G Fraser Journal: BMC Med Date: 2017-10-24 Impact factor: 8.775
Authors: Ankoor R Shah; Yoshihiro Yonekawa; Bozho Todorich; Lily Van Laere; Rehan Hussain; Maria A Woodward; Ashkan M Abbey; Jeremy D Wolfe Journal: J Vitreoretin Dis Date: 2017-02-01