Association of fecal occult blood tests results with colonoscopic findings in a general hospital and validation of the screening test

Abstract

Globally, colorectal cancer is the third leading cause of cancer death among men and the second among women, corresponding to about 10% of all cancers. The Brazilian Ministry of Health and National Cancer Institute recommend the screening of colorectal cancer for people over 50 years-old with Fecal Occult Blood Test. Endoscopy is limited to patients with positive screening results. The aim of this study is to evaluate the incidence of malignant or premalignant lesions diagnosed by endoscopy in patients with positive or negative Fecal Occult Blood Test and assess the efficacy of Fecal Occult Blood Test to predict the finding of a malignant colorectal lesion. We carried out a cross-sectional study among patients with a Fecal Occult Blood Test result that were submitted to colonoscopy, in the same hospital, from March 2016 to July 2017. Sensitivity, specificity, positive and negative predictive value of Fecal Occult Blood Test compared to colonoscopy neoplastic findings was calculated. The total of 92 patients were enrolled, 52 (56.5%) were female, Fecal Occult Blood Test was positive in 42.4% of them and in 41 (44.6%) the colonoscopy showed abnormal findings. Polyps were the most frequent alteration, found in 20 patients (21.7%). Among the patients with polyps, 15 (16.3%) had neoplastic and 5 (5.4%) presented non-neoplastic polyps. The Fecal Occult Blood Test sensitivity for detection of neoplastic polyps was 66.7%, specificity 62.3%, positive predictive value 11% and negative predictive value was 94.2%. Considering the need for a screening method, Fecal Occult Blood Test showed to be an effective and reliable screening test that can be applied in public health programs to detect and prevent colorectal cancer.

Comprehensive Volatilome and Metabolome Signatures of Colorectal Cancer in Urine: A Systematic Review and Meta-Analysis

“…Other factors affecting the PPV are sex (lower for females) and colorectal condition (lower for patients with a previous colorectal clinical history) [ 9 ]. Diverse studies report PPV values in the range of 10–30%, while the area under the ROC curve (AUC) is typically in the range of 0.7–0.9 [ 10 , 11 ]. Improvements in CRC screening are needed to minimize the cost and potential complications of subsequent colonoscopy.…”

Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using midazolam or fentanyl associated with propofol

“…Although it is a safe procedure, it is not free from complications such as bleeding, intestinal perforations, cardiorespiratory alterations and other side effects associated with the use of sedatives. 16 Therefore, it is essential that it be performed under a safe anesthetic technique, which allows for quick recovery, decreases the patient's length stay in the hospital environment and reduces the costs associated with the procedure. 10,11 This study differs from the others as it standardizes the level of sedation used in each patient and measures an objective clinical parameter of recovery: the post-anesthetic recovery time.…”

Urine NMR Metabolomics for Precision Oncology in Colorectal Cancer

“…Factors affecting the PPV are patient age (lower PPVs observed in younger patients), colorectal condition (lower for patients with a previous CRC clinical history), and sex (lower for females) [ 9 ]. FIT PPV values are in the range of 10–30%, while AUC (area under the ROC curve) is in the range of 0.7–0.9 [ 10 , 11 ]. However, even with the improvements in the performance of fecal tests, the number of false positives (FP) largely exceeds the number of true positives (TP).…”