Comparison of three faecal occult blood tests in the detection of colorectal neoplasia.

Abstract

Methods and Aims-For the detection of colorectal neoplasia, 192 consecutive patients had colonoscopy to evaluate the sensitivity and specificity of three faecal occult blood tests (FOBT (Gut 1996; 39: 722-725) Australia Ltd) uses a monoclonal antibody that is specific for human haemoglobin, which theoretically should decrease the number of false positive test results. The BM Test colon albumin (BMCA) (Boehringer Mannheim, UK) is designed to detect human albumin present in the faecal sample, which may be associated with colorectal neoplasia.The aim of this study is to evaluate the sensitivity and specificity of these three FOBTs as a means of detecting colorectal neoplasia. From March 1991 until November 1992 consecutive patients who required colonoscopy for the investigation of gastrointestinal symptoms or for 'polyp surveillance' follow up (see Figure), were recruited for study. In no case was colonoscopy being performed for previously positive FOBTs and patients with a history of overt gastrointestinal bleeding were excluded. No patient had undergone previous colonic resectional surgery. Patients were asked to start the testing of stools five days before hospital admission to ensure enough time to complete the three day regimen before bowel preparation. There were no dietary restrictions placed on the patients and regular medications were continued. Methods Patients

Effect of Verification Bias on the Sensitivity of Fecal Occult Blood Testing: a Meta-Analysis

“…The studies that evaluated the standard guaiac-based FOBT that did not correct for verification bias are listed in Table 1. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] In the last study, the data was presented in two separate publications. These 19 studies included 713 subjects with colorectal cancer and 4181 controls.…”

“…Both control-and cancersubjects underwent a confirmatory test, usually a colonoscopy though some of the older studies also utilized barium enema and sigmoidoscopy, particularly if FOBT negative. Most studies included subjects who submitted 3 stool specimens [31][32][33][34]36,37,39,41,44,[46][47][48][49][50] while some studies included subjects who only submitted one specimen 35,42,43 or the number was not specified. 38,40,45 Almost all of the studies reported that the specimens were collected at home while one study did not specify the location.…”

“…38,40,45 Almost all of the studies reported that the specimens were collected at home while one study did not specify the location. 38 The studies listed in Table 1 recruited subjects by two methods: inclusion of patients undergoing colonoscopy for a variety of indications (e.g., FOBT positivity, GI symptoms, colon cancer screening, polyp surveillance) [31][32][33][34][35][36][37][38][39]41,[44][45][46][47] or selection of a group of known colorectal cancer patients and controls undergoing colonoscopy. 40,42,43,[48][49][50] Both of these methods contain potential verification bias as not all of the FOBT negative patients in the population underwent a confirmatory test.…”

Quantitative Immunological Fecal Occult Blood Test Predicts Probability, Stage, and Location of Colorectal Cancer.

“…[7] There are many reviews comparing the IFOBT to the formerly methods. [4], [5], [17] decide the most suitable cut-off value universally by discussing the efficiency and the probability to detect cancer. [25] The most suitable cut off value have to be decided never to fail to pick up a colorectal cancer and to reduce the false positive rate as low as possible.…”

Cluster Randomization Trial of Sequence Mass Screening for Colorectal Cancer

“…The sensitivity of the monoclonal antibody method was superior to both Hemoccult ® II and BMTest colon albumin. Hope et al 17 concluded that the monoclonal antibody method, an FOBT that uses a monoclonal antibody specific to human hemoglobin, is a more accurate test in the detection of colorectal neoplasia and should be used in colorectal cancer screening programs. Unfortunately, as Yu and colleagues report, 9 only half of all colorectal cancers detected produce blood in the stool, with the remaining cancers producing false-negative results with the use of FOBT alone.…”