Comparative Evaluation of Immunochemical Fecal Occult Blood Tests for Colorectal Adenoma Detection

Hundt, Sabrina; Haug, Ulrike; Brenner, Hermann

doi:10.7326/0003-4819-150-3-200902030-00005

Cited by 306 publications

(241 citation statements)

References 21 publications

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“…These studies have used different types of FIT. This hampers a direct comparison of test results because the different types of FIT are known to vary considerably in sensitivity, from 25% to 72%, within the same population (8). Overall, the sensitivity of the OC sensor we used for the detection of subjects with advanced adenomas was in the lower range than in studies using (8,10,30).…”

Section: Discussionmentioning

confidence: 66%

“…Randomized trials have reported that screening using FOBT and sigmoidoscopy may reduce CRC mortality by 15% to 17% (4,5) and 31% (6), respectively. Test performance of the semiquantitative FIT appears to be superior to that of the guaiac-based FOBTs (7,8), but so far, results of randomized controlled trials on the effects of FIT on CRC mortality are lacking. Although many studies assessed the individual performance of FIT or sigmoidoscopy in various populations, only a few were conducted comparing both methods with colonoscopy as a reference standard in screening populations (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Test Performance of Immunologic Fecal Occult Blood Testing and Sigmoidoscopy Compared with Primary Colonoscopy Screening for Colorectal Advanced Adenomas

Bakker

Jonkers

Sanduleanu

et al. 2011

Cancer Prevention Research

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Given the current increase in colorectal cancer screening, information on performance of screening tests is needed, especially in groups with a presumed lower test performance. We compared test performance of immunologic fecal occult blood testing (FIT) and pseudosigmoidoscopy with colonoscopy for detection of advanced adenomas in an average risk screening population. In addition, we explored the influence of gender, age, and location on test performance. FIT was collected prior to colonoscopy with a 50 ng/mL cutoff point. FIT results and complete colonoscopy findings were available from 329 subjects (mean age: 54.6 AE 3.7 years, 58.4% women). Advanced adenomas were detected in 38 (11.6%) of 329 subjects. Sensitivity for advanced adenomas of FIT and sigmoidoscopy were 15.8% (95% CI: 6.0-31.3) and 73.7% (95% CI: 56.9-86.6), respectively. No sensitivity improvement was obtained using the combination of sigmoidoscopy and FIT. Mean fecal hemoglobin in FIT positives was significantly lower for participants with only proximal adenomas versus those with distal ones (P ¼ 0.008), for women versus men (P ¼ 0.023), and for younger (<55 years) versus older (!55 years) subjects (P ¼ 0.029). Sensitivities of FIT were 0.0% (95% CI: 0.0-30.9) in subjects with only proximal versus 21.4% (95% CI: 8.3-41.0) in those with distal nonadvanced adenomas; 5.3% (95% CI: 0.0-26.0) in women versus 26.3% (95% CI: 9.2-51.2) in men; 9.5% (95% CI: 1.2-30.4) in younger versus 23.5% (95% CI: 6.8-49.9) in older subjects. Sigmoidoscopy had a significantly higher sensitivity for advanced adenomas than FIT. A single FIT showed very low sensitivity, especially in subjects with only proximal nonadvanced adenomas, in women, and in younger subjects. This points to the existence of "low" FIT performance in subgroups and the need for more tailored screening strategies. Cancer Prev Res; 4(10); 1563-71. Ó2011 AACR.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Test Performance of Immunologic Fecal Occult Blood Testing and Sigmoidoscopy Compared with Primary Colonoscopy Screening for Colorectal Advanced Adenomas

Bakker

Jonkers

Sanduleanu

et al. 2011

Cancer Prevention Research

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“…Die Sensitivität und Spezifität von in Deutschland verfügbaren iFOBT variiert deutlich, so dass der generelle Einsatz aller iFOBT nicht empfohlen werden kann [141]. Es erscheint vielmehr erforderlich, dass für jeden iFOBT, der für die Krebsfrüherkennung eingesetzt werden soll, individuell eine ausreichend hohe Sensitivität und vor allem Spezifität nachgewiesen wird.…”

Section: Level Of Evidence 3aunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

147

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“…In screening tests, individuals with a positive fecal immunological test (FIT) are referred for colonoscopy (gold standard). However, performance of this test is suboptimal, with sensitivity for CRC and advanced adenomas of 66-87% and 27-38%, respectively, depending on cut-off value used [45][46][47][48]. In addition, screening with FIT results in a substantial number of false positive tests, and as a consequence, unneeded colonoscopies.…”

Section: Colorectal Cancermentioning

confidence: 99%

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

et al. 2018

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Abstract:Increasing interest is noticed in the potential of volatile organic compound (VOC) analysis as non-invasive diagnostic biomarker in clinical medical practice. The spectrum of VOCs, originating from (patho)physiological metabolic processes in the human body and detectable in bodily excrements, such as exhaled breath, urine and feces, harbors a magnificent source of information. Thus far, the majority of studies have focused on VOC analysis in exhaled breath, aiming at identification of disease-specific VOC profiles. Recently, an increasing number of studies have evaluated the usability of VOC present in the headspace of feces in the diagnostic work-up of a wide range of gastrointestinal diseases. Promising results have been demonstrated particularly in those diseases in which microbiota alterations are considered to play a significant etiological role, such as colorectal carcinoma, inflammatory bowel disease, irritable bowel syndrome, celiac disease and infectious bowel diseases. In addition, fecal VOC analysis seems to have potential as a diagnostic biomarker for extra-intestinal diseases, including bronchopulmonary dysplasia and sepsis. Different methods for VOC analysis have been used in medical studies, such as gas-chromatography mass spectrometry, selected-ion flow tube-mass spectrometry, ion-mobility spectrometry, and electronic nose devices. In this review, the available literature on the potential of fecal VOCs as diagnostic biomarker, including an overview of relevant VOC detection techniques, is discussed. In addition, future hurdles, which need to be taken prior to implementation of VOC analysis in daily clinical practice, are outlined.

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Comparative Evaluation of Immunochemical Fecal Occult Blood Tests for Colorectal Adenoma Detection

Abstract: The German Research Foundation (Deutsche Forschungsgemeinschaft) within the framework of a PhD program (Graduiertenkolleg 793).

Cited by 306 publications

References 21 publications

Test Performance of Immunologic Fecal Occult Blood Testing and Sigmoidoscopy Compared with Primary Colonoscopy Screening for Colorectal Advanced Adenomas

Test Performance of Immunologic Fecal Occult Blood Testing and Sigmoidoscopy Compared with Primary Colonoscopy Screening for Colorectal Advanced Adenomas

S3-Leitlinie – Kolorektales Karzinom

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

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