A Comparison of the Immunochemical Fecal Occult Blood Test and Total Colonoscopy in the Asymptomatic Population

Morikawa, Tamiya; Kato, Jun; Yamaji, Yutaka; Wada, Ryoichi; Mitsushima, Toru; Shiratori, Yasushi

doi:10.1053/j.gastro.2005.05.056

Cited by 241 publications

(172 citation statements)

References 36 publications

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“…There are several cross-sectional studies that provide test characteristics of FITs with or without a comparative gFOBT group and with colonoscopy as the reference standard [28,29,30,31,32]. These studies show that FITs are associated with higher participation rates, higher positivity rates, greater sensitivity for CRC and advanced adenoma, but slightly lower specificity.…”

Section: Currently Recommended Testsmentioning

confidence: 99%

Noninvasive Screening Tests for Colorectal Cancer

Imperiale¹

2012

Dig Dis

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Background: Identifying an accurate, reliable, affordable, and acceptable noninvasive screening test for colorectal cancer (CRC) would greatly facilitate population screening. Methods: Published literature from 2000 through February 2012 on noninvasive CRC screening tests was identified, reviewed, and summarized. Results: The highest quality evidence for noninvasive screening exists for guaiac-based fecal occult blood tests (gFOBTs), for which the CRC-specific incidence and mortality reductions are modest. Fecal immunochemical tests (FITs) offer better sensitivity and comparable specificity. Cross-sectional studies comparing gFOBTs and FITs suggest that FITs provide higher detection of advanced neoplasia. Modeling studies favor FITs over gFOBTs with respect to effectiveness and cost-effectiveness. A myriad of studies report the performance of fecal-based and blood-based genetic and protein-based biomarkers; the studies differ in patient population assembled, marker selection, and assay methods. Several markers and panels of markers are promising, although nearly all studies focus on new markers and/or assay methods on small sets of referred patients rather than validating markers using optimal assays in a screening setting. Conclusion: In the absence of long-term randomized trials, adoption of the noninvasive tests will require cross-sectional data on test characteristics obtained from the screening setting, where CRC prevalence is low and the full spectrum of colorectal findings exists, along with estimates of cumulative risks, benefits, and cost-effectiveness. Test adoption will ultimately depend on test characteristics, availability, affordability, and user appeal. There is no noninvasive substitute for the currently recommended screening tests. FITs should replace gFOBTs wherever gFOBTs are used for screening.

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Section: Currently Recommended Testsmentioning

confidence: 99%

Noninvasive Screening Tests for Colorectal Cancer

Imperiale¹

2012

Dig Dis

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“…There are colonoscopic screening studies but most of the studies have been performed in men [7][8][9][10], although women alone have also been studied [11]. Selection by age is common; most studies have a focus on the age group 50-75, but also cohorts including younger age groups have been studied [12,13].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of colonic neoplasia and advanced lesions in the normal population: a prospective population-based colonoscopy study

Forsberg

Kjellström

Agréus

et al. 2012

Scandinavian Journal of Gastroenterology

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“…Recently, immunochemical FOBT (FIT) screening has become available. FIT has a better sensitivity and similar specificity for detecting advanced neoplasia compared to the gFOBT,8 10 11 12 13 14 15 since it specifically detects human haemoglobin. Sigmoidoscopy screening is possibly more effective than FOBT screening due to the considerable higher sensitivity for detection of early neoplastic lesions and the possibility of removing adenomas during the screening procedure 16 17.…”

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confidence: 99%