Table I.
A summarization of bibliographical references to FOBT sensitivity and specificity.
| Author/(Refs.) | Faecal occult blood testing |
|---|---|
| Kronborg et al (185), Scholefield et al (186) | Reduction in CRC mortality with gFOBT biannually [relative risk reductions of 13% (UK trial) and 16% (Danish trial)] |
| No significant reduction in overall mortality | |
| gFOBT: Low sensitivity for CRC detection (UK trial, 45%; Danish trial, 54%) | |
| True-positive rate: 50% (UK and Danish trials) | |
| False-positive rate: 5–10% (UK and Danish trials) | |
| True-negative rate: 90–95% (UK and Danish trials) | |
| False-negative rate 50% (UK and Danish trials) | |
| Medical Advisory Secretariat (187), Dancourt et al (188), Faivre et al (189) | iFOBT sensitivity superior to those of gFOBT for CRC detection: Two studies showed sensitivity for gFOBT, 13 and 25%, respectively; pooled iFOBT sensitivity, 81% iFOBT and gFOBT: Lower sensitivities for adenoma detection than for CRC detection: Rehydrated gFOBT, 22%; pooled iFOBT, 28% |
| Lin et al (190) | FIT sensitivity, 73.8% (95% CI, 62.3 to 83.3) for quantitative (n=9,989) test categories; 78.6% (95% CI, 61.0 to 90.5) for qualitative (n=18,296) test categories |
| Koo et al (191), Moss et al (192) | Positive predictive value of FIT > positive predictive value gFOBT for advanced adenoma (1.73 vs. 0.35%) and all neoplasias (3.74 vs. 0.76%) FIT detects twice more CRCs and advanced adenomas |
| Gonzalez-Pons and Cruz-Correa (8) | gFOBT: ↓ ability to define bleeding between upper/lower GI tract |
| Kuipers et al (10) | gFOBT: ↓ ability to distinguish human haeme |
| Valori et al (62) | gFOBT: Νot sensitive in small bleedings |
| gFOBT ↓ sensitivity in detecting cancerous/preneoplastic lesions | |
| gFOBT: Specificity affected by diet/drugs | |
| Lieberman et al (63) | gFOBT: 18% sensitivity in detecting advanced adenomas |
| Whitlock et al (65), Young et al (64) | FITs sensitivity for advanced adenomas: ~20–67% (↑ than FOBT) |
| Dancourt et al (188) | FIT detects more CRC and advanced neoplasia than gFBOT (similar positive predictive value) |
| Imperiale et al (25) | |
| Rozen et al (193) | Comparative performance of gFOBT and FIT depends on the number of samples and threshold chosen for the quantitative FIT |
| Hoffman et al (194) | Screening adherence with FIT was higher than with gFOBT (61.4 vs. 50.5%) |
| Brenner and Tao (195) | Sensitivity of FITs for detecting CRC/any advanced neoplasm/any neoplasm: 2–3 times higher than gFBOT |
| Increased levels of FITs specificity vs. gFOBT | |
| Fitzpatrick-Lewis et al (196) | iFOBT vs. gFOBT on mortality outcomes: iFOBT has higher sensitivity and comparable specificity (insufficient evidence from RCTs) |
| Murphy et al (197) | Total financial burden: Lower for FIT at any threshold (expressed in µg Hb/g faeces) than for gFOBT, and this difference increases as the FIT threshold is decreased (Cohort-based Markov state transition model) |
| Lee et al (198) | FIT sensitivity, 79%; FIT specificity, 94% |
| Morikawa et al (66) | gFOBT detect notably more lesions in the left (compared to the right colon) |
FOBT, faecal occult blood test; CRC, colorectal cancer; gFOBT, guaiac faecal occult blood test; FIT, faecal immunochemical test; RCT, randomized controlled trials.