Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectal cancer

Nakama, Hidenori; Zhang, B.; Zhang, X.

doi:10.1016/s0959-8049(00)00387-7

Cited by 52 publications

(54 citation statements)

References 12 publications

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“…Several studies have suggested that immunochemical FOBT (I-FOBT) is more sensitive and specific than G-FOBT Saito et al, 2000;Zappa et al, 2001; Levi et al, 2006;Guittet et al, 2007), requiring no dietary restrictions, and might substantially improve screening cost effectiveness Saito et al, 2000). Further progress in I-FOBT use was made by the introduction of the latex agglutination test (LAT), a quantitative and fully automated test (Yamamoto et al, 1990), which made it possible to choose the positivity cutoff values to optimise the balance between sensitivity and specificity, though the debate about the optimal cutoff point continues (Itoh et al, 1996;Castiglione et al, 2000;Nakama et al, 2001;Edwards, 2005;Vilkin et al, 2005). Sensitivity of G-FOBT and a previously used I-FOBT (reversed passive haemagglutination (RPHA)) for CRC, based on proportional interval cancer incidence, was determined previously (Zappa et al, 2001).…”

mentioning

confidence: 99%

Sensitivity of latex agglutination faecal occult blood test in the Florence District population-based colorectal cancer screening programme

Castiglione¹,

Visioli²,

Ciatto³

et al. 2007

Br J Cancer

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We evaluated the sensitivity for colorectal cancer (CRC) of the latex agglutination test (LAT), an immunochemical test routinely used in the Florence District screening programme since 2000. Sensitivity was calculated by the proportional interval cancer incidence method in a population of 27 503 consecutive subjects screened in 2000 -2002, interval cancers being identified by linkage to the Tuscany Cancer Registry files. Sensitivity was calculated overall and by gender, age, time since last negative LAT, CRC site, and rank of screening. Overall 1-and 2-year sensitivity estimates were 80.7 and 71.5%, respectively, suggesting that faecal occult blood testing screening sensitivity may be suboptimal due to testing or programme quality problems. Increasing screening sensitivity might be achieved if the detection rate of advanced adenomas could be increased without unacceptable loss in specificity.

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mentioning

confidence: 99%

Sensitivity of latex agglutination faecal occult blood test in the Florence District population-based colorectal cancer screening programme

Castiglione¹,

Visioli²,

Ciatto³

et al. 2007

Br J Cancer

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“…Considering economic aspects, we took advantage of q-FIT to achieve an increase in test sensitivity by decreasing the cut-off value and, with respect to specificity; we chose the best cut-off point using a q-FIT. The technology of q-FIT ensures ideal sensitivity/specificity ratio by virtue of the quantitative results [18][19][20][21] . The lower proportion of complete colonoscopies in our survey was due to the exclusion of patients with poor preparation who were not willing to undergo repeated colonoscopy within the specified time-frame.…”

Section: Discussionmentioning

confidence: 99%

Improvements in colorectal cancer screening programmes - quantitative immunochemical faecal occult blood testing - how to set the cut-off for a particular population

Kovarova¹,

Zavoral²,

Zima³

et al. 2012

BIOMED PAP

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Objective. The aim of the study was to determine the optimum cut-off value of the quantitative immunochemical test (q-FIT) OC-Sensor® for colorectal cancer and advanced adenomatous polyps in a particular population. Methods. 815 patients were referred for colonoscopy and were offered two q-FIT examinations at two different colonoscopy centers. The patients were classified according to the colonoscopic findings. Test sensitivity, specificity, and accuracy were statistically evaluated using one test and two tests at the levels of 50, 75, 100, 125, and 150 ng/mL of faecal hemoglobin in those patients with advanced polyps and colorectal cancer. The optimum cut-off test level for clinically significant neoplasia was determined using one test. Results. The optimum cut-off value of q-FIT OC-Sensor ® for the detection of clinically significant neoplasia in our particular population was determined as 75 ng/mL using one test. This value provides an optimum proportion of 73% sensitivity (±95% CI 60.3% -83.4%) and 90% specificity (±95% CI 86.8% -92.8%), PPV and NPV were determined as 54.76% and 95.43% respectively. Conclusions. The first step in the implementation of q-FIT test in the screening program in our country is to determine the optimum cut-off level for a population, and to estimate the number of tests performed with respect to the optimum cost effectiveness and economical climate. Using one test, the optimum level of q-FIT OC-Sensor® in the Czech Republic was determined as 75 ng/mL. This study could serve as a model for further studies in other countries, where screening does not yet exist.

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“…Physiologic blood loss from the gastrointestinal tract has been estimated to be 0.32±0.09 mg/g stool (20). Nakama et al (21) reported that 150 ng/ml of fecal hemoglobin was the optimal cut-off point when carrying out the OC-hemodia test as a means of screening for colorectal cancer, but no significant difference was observed in the specificities between 50 and 150 ng/ml. In our study, a positive FOBT result was defined as ＞ 100 ng/ml fecal hemoglobin.…”

Section: Discussionmentioning

confidence: 99%

Single Immunochemical Fecal Occult Blood Test for Detection of Colorectal Neoplasia

et al. 2005

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Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectal cancer

Cited by 52 publications

References 12 publications

Sensitivity of latex agglutination faecal occult blood test in the Florence District population-based colorectal cancer screening programme

Sensitivity of latex agglutination faecal occult blood test in the Florence District population-based colorectal cancer screening programme

Improvements in colorectal cancer screening programmes - quantitative immunochemical faecal occult blood testing - how to set the cut-off for a particular population

Single Immunochemical Fecal Occult Blood Test for Detection of Colorectal Neoplasia

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