Abstract
An established chemical faecal occult blood test (Haemoccult prepared without rehydration) has been compared with a new immunological test (Hemeselect) in patients referred for investigation of lower gastro-intestinal symptoms. Hemeselect was shown to have a higher sensitivity for colorectal carcinoma (94.0% compared with 58.0%), the greatest difference in sensitivity between the two tests being for rectal cancers. Similarly Hemeselect was more sensitive than Haemoccult for colorectal adenomas (66.6% vs 33.3%), and for inflammatory bowel disease (88.9% vs 33.3%). However the enhanced sensitivity of Hemeselect for colorectal neoplasia and inflammatory bowel disease was accompanied by a significant increase in the overall rate of positive reactions (32.8% of patients had a positive Hemeselect reaction compared with 14.8% who had a positive Haemoccult test), and a reduction in specificity (84.1% for Hemeselect vs 96.0% for Haemoccult). Hemeselect is a more sensitive indicator of colorectal neoplasia in symptomatic subjects, trials of its use as a screening test for asymptomatic neoplasia appear justified.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adlercreutz H., Partanen P., Virkola P., Liewendahl K., Turunen M. J. Five guaiac-based tests for occult blood in faeces compared in vitro and in vivo. Scand J Clin Lab Invest. 1984 Oct;44(6):519–528. doi: 10.1080/00365518409083605. [DOI] [PubMed] [Google Scholar]
- Barrison I. G., Parkins R. A. The clinical value of Haemoccult and Fecatwin in the detection of colorectal neoplasia in hospital and general practice patients. Postgrad Med J. 1985 Aug;61(718):701–704. doi: 10.1136/pgmj.61.718.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farrands P. A., Hardcastle J. D. Accuracy of occult blood tests over a six-day period. Clin Oncol. 1983 Sep;9(3):217–225. [PubMed] [Google Scholar]
- Hardcastle J. D., Thomas W. M., Chamberlain J., Pye G., Sheffield J., James P. D., Balfour T. W., Amar S. S., Armitage N. C., Moss S. M. Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Results for first 107,349 subjects. Lancet. 1989 May 27;1(8648):1160–1164. doi: 10.1016/s0140-6736(89)92750-5. [DOI] [PubMed] [Google Scholar]
- Kewenter J., Björk S., Haglind E., Smith L., Svanvik J., Ahrén C. Screening and rescreening for colorectal cancer. A controlled trial of fecal occult blood testing in 27,700 subjects. Cancer. 1988 Aug 1;62(3):645–651. doi: 10.1002/1097-0142(19880801)62:3<645::aid-cncr2820620333>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Kronborg O., Fenger C., Olsen J., Bech K., Søndergaard O. Repeated screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen, Denmark. Scand J Gastroenterol. 1989 Jun;24(5):599–606. doi: 10.3109/00365528909093096. [DOI] [PubMed] [Google Scholar]
- Leicester R. J., Lightfoot A., Millar J., Colin-Jones D. G., Hunt R. H. Accuracy and value of the Hemoccult test in symptomatic patients. Br Med J (Clin Res Ed) 1983 Feb 26;286(6366):673–674. doi: 10.1136/bmj.286.6366.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mandel J. S., Bond J. H., Bradley M., Snover D. C., Church T. R., Williams S., Watt G., Schuman L. M., Ederer F., Gilbertsen V. Sensitivity, specificity, and positive predictivity of the Hemoccult test in screening for colorectal cancers. The University of Minnesota's Colon Cancer Control Study. Gastroenterology. 1989 Sep;97(3):597–600. doi: 10.1016/0016-5085(89)90629-x. [DOI] [PubMed] [Google Scholar]
- Thomas W. M., Pye G., Hardcastle J. D., Chamberlain J., Charnley R. M. Role of dietary restriction in Haemoccult screening for colorectal cancer. Br J Surg. 1989 Sep;76(9):976–978. doi: 10.1002/bjs.1800760935. [DOI] [PubMed] [Google Scholar]