Abstract
Seven hundred and eighty-six subjects spontaneously referring to our Center performed two guaiac (Rehydrated Hemoccult II (R.HO), and Hemoccult Sensa (HO S.)), and two immunochemical (OC Hemodia (Hdia) and Hemeselect (Hsel)) faecal occult blood tests on three consecutive faecal determinations. The positivity rates of 3 day R.HO, HO S., Hdia, and Hsel were 4.8%, 5.6%, 8.4% and 11.2% respectively. One hundred and thirty-five of the 150 subjects with at least one positive test completed the diagnostic work-up. Cancer was detected in three subjects and adenomas in 15. Three-day specificity estimates of R.HO, HO S., Hdia and Hsel in the overall series were 96.1%, 96.0%, 93.8% and 91.2% respectively, the differences between guaiac and immunochemical tests being significant. Corresponding values of specificity as determined on the first faecal sample only in the overall series were 98.1%, 98.3%, 96.1% and 94.9% respectively. No significant difference in specificity is evident when 3-day guaiac tests are compared to 1-day immunochemical ones. Three-day immunochemical testing is not recommended for screening purposes due to its very low specificity. Nevertheless, 1-day immunochemical testing is almost as specific as 3-day guaiac testing. A preliminary estimate of colonic neoplasms detection rates shows no difference as well. The benefit of 1-day testing on screening acceptability is evident, but the impact on sensitivity should be evaluated in a screening situation with a proper study design and a larger sample size.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bertario L., Spinelli P., Gennari L., Sala P., Pizzetti P., Severini A., Cozzi G., Bellomi M., Berrino F. Sensitivity of Hemoccult test for large bowel cancer in high-risk subjects. Dig Dis Sci. 1988 May;33(5):609–613. doi: 10.1007/BF01798365. [DOI] [PubMed] [Google Scholar]
- Castiglione G., Grazzini G., Poli A., Bonardi R., Ciatto S. Hemoccult sensitivity estimate in a screening program for colorectal cancer in the Province of Florence. Tumori. 1991 Jun 30;77(3):243–245. doi: 10.1177/030089169107700312. [DOI] [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]