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Article: A sensitive guaiac faecal occult blood test is less useful than an immunochemical test for colorectal cancer screening in a Chinese population

TitleA sensitive guaiac faecal occult blood test is less useful than an immunochemical test for colorectal cancer screening in a Chinese population
Authors
Issue Date2003
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 2003, v. 18 n. 9, p. 941-946 How to Cite?
AbstractBackground: Colorectal cancer screening by guaiac faecal occult blood test has been shown to reduce the incidence and mortality of colorectal cancer in Western populations. The optimal faecal occult blood test, whether guaiac or immunochemical, for colorectal cancer screening in the Chinese population remains to be defined. Aim: To compare the performance characteristics of a sensitive guaiac-based faecal occult blood test (Hemoccult SENSA) and an immunochemical faecal occult blood test (FlexSure OBT) in a Chinese population referred for colonoscopy. Methods: One hundred and thirty-five consecutive patients who were referred for colonoscopy and who met the study inclusion criteria took samples for the two faecal occult blood tests simultaneously from three successive stool specimens, with no dietary restrictions. All tests were developed and interpreted by a single experienced technician who was blind to the clinical diagnosis. The sensitivity, specificity and positive predictive value for the detection of colorectal adenomas and cancers were estimated for the two tests. Results: The sensitivity, specificity and positive predictive value for the detection of significant colorectal neoplasia (adenomas ≥ 1.0 cm and cancers) were 91%, 70% and 18% for Hemoccult SENSA and 82%, 94% and 47% for FlexSure OBT. The specificity and positive predictive value were significantly higher for FlexSure OBT than for Hemoccult SENSA (P < 0.001 and P = 0.016, respectively). Combining the positive results from both faecal occult blood tests did not improve the accuracy. Conclusion: The positive predictive value of the immunochemical faecal occult blood test for the detection of significant colorectal neoplasia was 29% better than that of the sensitive guaiac-based test. This may relate to the Chinese diet and requires further study. The poor specificity of the sensitive guaiac-based test, without dietary restriction, makes it less useful for colorectal cancer screening in a Chinese population.
Persistent Identifierhttp://hdl.handle.net/10722/162766
ISSN
2015 Impact Factor: 6.32
2015 SCImago Journal Rankings: 2.833
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, BCYen_US
dc.contributor.authorWong, WMen_US
dc.contributor.authorCheung, KLen_US
dc.contributor.authorTong, TSMen_US
dc.contributor.authorRozen, Pen_US
dc.contributor.authorYoung, GPen_US
dc.contributor.authorChu, KWen_US
dc.contributor.authorHo, Jen_US
dc.contributor.authorLaw, WLen_US
dc.contributor.authorTung, HMen_US
dc.contributor.authorLai, KCen_US
dc.contributor.authorHu, WHCen_US
dc.contributor.authorChan, CKen_US
dc.contributor.authorLam, SKen_US
dc.date.accessioned2012-09-05T05:23:14Z-
dc.date.available2012-09-05T05:23:14Z-
dc.date.issued2003en_US
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2003, v. 18 n. 9, p. 941-946en_US
dc.identifier.issn0269-2813en_US
dc.identifier.urihttp://hdl.handle.net/10722/162766-
dc.description.abstractBackground: Colorectal cancer screening by guaiac faecal occult blood test has been shown to reduce the incidence and mortality of colorectal cancer in Western populations. The optimal faecal occult blood test, whether guaiac or immunochemical, for colorectal cancer screening in the Chinese population remains to be defined. Aim: To compare the performance characteristics of a sensitive guaiac-based faecal occult blood test (Hemoccult SENSA) and an immunochemical faecal occult blood test (FlexSure OBT) in a Chinese population referred for colonoscopy. Methods: One hundred and thirty-five consecutive patients who were referred for colonoscopy and who met the study inclusion criteria took samples for the two faecal occult blood tests simultaneously from three successive stool specimens, with no dietary restrictions. All tests were developed and interpreted by a single experienced technician who was blind to the clinical diagnosis. The sensitivity, specificity and positive predictive value for the detection of colorectal adenomas and cancers were estimated for the two tests. Results: The sensitivity, specificity and positive predictive value for the detection of significant colorectal neoplasia (adenomas ≥ 1.0 cm and cancers) were 91%, 70% and 18% for Hemoccult SENSA and 82%, 94% and 47% for FlexSure OBT. The specificity and positive predictive value were significantly higher for FlexSure OBT than for Hemoccult SENSA (P < 0.001 and P = 0.016, respectively). Combining the positive results from both faecal occult blood tests did not improve the accuracy. Conclusion: The positive predictive value of the immunochemical faecal occult blood test for the detection of significant colorectal neoplasia was 29% better than that of the sensitive guaiac-based test. This may relate to the Chinese diet and requires further study. The poor specificity of the sensitive guaiac-based test, without dietary restriction, makes it less useful for colorectal cancer screening in a Chinese population.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_US
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_US
dc.rightsAlimentary Pharmacology and Therapeutics. Copyright © Blackwell Publishing Ltd.-
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshChina - Ethnologyen_US
dc.subject.meshColorectal Neoplasms - Diagnosis - Ethnologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunologic Tests - Methodsen_US
dc.subject.meshMaleen_US
dc.subject.meshMass Screening - Methodsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOccult Blooden_US
dc.subject.meshSensitivity And Specificityen_US
dc.titleA sensitive guaiac faecal occult blood test is less useful than an immunochemical test for colorectal cancer screening in a Chinese populationen_US
dc.typeArticleen_US
dc.identifier.emailWong, BCY:bcywong@hku.hken_US
dc.identifier.emailLaw, WL:lawwl@hkucc.hku.hken_US
dc.identifier.authorityWong, BCY=rp00429en_US
dc.identifier.authorityLaw, WL=rp00436en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1046/j.1365-2036.2003.01783.xen_US
dc.identifier.pmid14616158-
dc.identifier.scopuseid_2-s2.0-10744219779en_US
dc.identifier.hkuros88232-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10744219779&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume18en_US
dc.identifier.issue9en_US
dc.identifier.spage941en_US
dc.identifier.epage946en_US
dc.identifier.isiWOS:000186566400009-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridWong, BCY=7402023340en_US
dc.identifier.scopusauthoridWong, WM=7403972413en_US
dc.identifier.scopusauthoridCheung, KL=7402406543en_US
dc.identifier.scopusauthoridTong, TSM=7102587364en_US
dc.identifier.scopusauthoridRozen, P=7006399927en_US
dc.identifier.scopusauthoridYoung, GP=7402900227en_US
dc.identifier.scopusauthoridChu, KW=7402453653en_US
dc.identifier.scopusauthoridHo, J=7402649983en_US
dc.identifier.scopusauthoridLaw, WL=7103147867en_US
dc.identifier.scopusauthoridTung, HM=7006351410en_US
dc.identifier.scopusauthoridLai, KC=7402135595en_US
dc.identifier.scopusauthoridHu, WHC=25932937100en_US
dc.identifier.scopusauthoridChan, CK=7404813960en_US
dc.identifier.scopusauthoridLam, SK=7402279473en_US

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