Table 4. Comparison of ANN to conventional screening methods.

Screening method	Sensitivity, Specificity and/or PPV	Advantages	Disadvantages
Artificial neural network (ANN) trained with NHIS data years 1997–2016 tested on ten random splits	● Sensitivity ~ of 0.57 ± 0.03 ● Specificity ~ of 0.89 ± 0.02 ● PPV ~ of 0.0075 ± 0.0003	● Better performance w/more training data ● Privacy ● Inexpensive ● Stage-independent ● Can stratify risk	● Low PPV ● Assumes integrity of data ● Only correlation ● Cannot be used for screening
Guaiac or immunoassay fecal occult blood test (gFOBT or iFOBT)	● Sensitivity ~ 0.9 ● Specificity ~ 0.9 ● PPV ~ 0.02	● No pre-test colon-cleansing ● Privacy ● Non-invasive	● Low PPV ● Pre-test diet ● False-positives ● Depends on CRC stage ● Moderately expensive
● Fecal immunochemical test (FIT) ● Fecal immunochemical DNA test (FIT-DNA)	(1) For FIT: ● Sensitivity ~ 0.1 ● Specificity ~ 0.9 ● PPV ~ 0.4 (2) For FIT-DNA: ● Sensitivity ~ 0.2 ● Specificity ~ 0.9 ● PPV ~ 0.5	● No pre-test colon-cleansing ● Privacy ● Inexpensive ($14) ● Non-invasive	● Adenoma insensitivity ● False-positives ● Low PPV ● Depends on CRC stage
Methylated SEPT9 gene test	● Sensitivity ~ 0.6 at Stage I. ● Sensitivity ~ 0.9 at Stage IV.	● No pre-test colon-cleansing ● Privacy ● Noninvasive	● Moderately expensive ● Depends on CRC stage
Flexible sigmoidoscopy	● Sensitivity ~ 0.6 ● Specificity ~ 0.7 ● PPV ~ 0.8	● Able to perform biopsy/polypectomy ● Less colon-cleansing ● No sedation	● Only rectum, lower-colon ● Dieting, bowel cleansing ● Invasive ● Expensive
Virtual colonoscopy	● Sensitivity ~ 0.6 ● Specificity ~ 0.7 ● PPV ~ 0.8	● Noninvasive ● Sedation unneeded ● Better at identifying advanced adenomas.	● Colon-cleansing ● Ionizing radiation ● Expensive (~$8000 in costs and charges)