Colonoscopy‐controlled intra‐individual comparisons to screen relevant neoplasia: faecal immunochemical test vs. guaiac‐based faecal occult blood test

Aliment Pharmacol Ther 31, 432–439 Summary Background Guaiac‐based faecal occult blood tests (g‐FOBTs) are most commonly used in colorectal cancer (CRC) screening programmes. Faecal immunochemical tests (FITs) are thought to be superior. Aim To compare performance of a g‐FOBT and a quantitative FI...

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Published in:	Alimentary pharmacology & therapeutics Vol. 31; no. 3; pp. 432 - 439
Main Authors:	OORT, F. A., TERHAAR SIVE DROSTE, J. S., VAN DER HULST, R. W. M., VAN HEUKELEM, H. A., LOFFELD, R. J. L. F., WESDORP, I. C. E., VAN WANROOIJ, R. L. J., DE BAAIJ, L., MUTSAERS, E. R., VAN DER REIJT, S., COUPE, V. M. H., BERKHOF, J., BOUMAN, A. A., MEIJER, G. A., MULDER, C. J. J.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-02-2010
Subjects:	Adolescent Adult Aged Aged, 80 and over Colonoscopy - methods Colorectal Neoplasms - pathology Early Detection of Cancer - methods Feces Female Guaiac Humans Immunohistochemistry Indicators and Reagents Male Mass Screening - methods Middle Aged Occult Blood Predictive Value of Tests Sensitivity and Specificity Young Adult
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Summary:	Aliment Pharmacol Ther 31, 432–439 Summary Background Guaiac‐based faecal occult blood tests (g‐FOBTs) are most commonly used in colorectal cancer (CRC) screening programmes. Faecal immunochemical tests (FITs) are thought to be superior. Aim To compare performance of a g‐FOBT and a quantitative FIT for detection of CRCs and advanced adenomas in a colonoscopy‐controlled population. Methods We assessed sensitivity and specificity of both FIT (OC‐sensor) and g‐FOBT (Hemoccult‐II) prior to patients’ scheduled colonoscopies. Results Of the 62 invasive cancers detected in 1821 individuals, g‐FOBT was positive in 46 and FIT in 54 (74.2% vs. 87.1%, P = 0.02). Among 194 patients with advanced adenomas, g‐FOBT was positive in 35 and FIT in 69 (18.0% vs. 35.6%, P < 0.001). Sensitivity for screen relevant tumours (197 advanced adenomas and 28 stage I or II cancers) was 23.0% for g‐FOBT and 40.5% for FIT (P < 0.001). Specificity of g‐FOBT compared to FIT for the detection of cancer was 95.7% vs. 91.0%, P < 0.001) and for advanced adenomas (97.4% vs. 94.2%, P < 0.001). Conclusions Faecal immunochemical test is more sensitive for CRC and advanced adenomas. Sensitivity of FIT for screen relevant tumours, early‐stage cancers and advanced adenomas, is significantly higher. Specificity of g‐FOBT is higher compared with FIT.
Bibliography:	Both authors contributed equally to this work. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0269-2813 1365-2036
DOI:	10.1111/j.1365-2036.2009.04184.x