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News

Fecal occult blood test for colorectal cancer detection

Sensitivity differs according to the tumor location, and programmatic and repeated screening by immunochemical fecal occult blood test may be necessary to increase sensitivity for colorectal cancer detection, finds August's Gastroenterology.

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The fecal occult blood test is recommended as a screening test for colorectal cancer.

There are few reliable studies on the accuracy of immunochemical fecal occult blood test.

Dr Tamiya Morikawa and colleagues analyzed the sensitivity of immunochemical fecal occult blood test.

The researchers compared the results with the findings from complete colonoscopy.

The patients included asymptomatic adults underwent 1-time immunochemical fecal occult blood test and total colonoscopy simultaneously.

The prevalence and location of colorectal neoplasia were determined by colonoscopy.

The sensitivity of fecal occult blood test for detecting invasive cancer was 66%
Gastroenterology

The research team compared the results of immunochemical fecal occult blood test and the colonoscopic findings.

Of 21,805 patients, the team found that immunochemical fecal occult blood test was positive in 1231 cases.

The sensitivity of 1-time immunochemical fecal occult blood test for detecting advanced neoplasia and invasive cancer was 27% and 66%, respectively.

In addition, the team noted that the sensitivity for invasive cancer according to Dukes' stage showed 50% for Dukes' stage A.

Sensitivity for invasive cancer for Dukes' stage B was 70%, and 78% for Dukes' stages C or D.

The researchers observed that the sensitivity for detecting advanced neoplasia at the proximal colon was significantly lower than that detected in the distal colon.

Dr Morikawa's team concluded, “Although the screening of asymptomatic patients with immunochemical fecal occult blood test can identify patients with colorectal neoplasia to a certain extent, the sensitivity is relatively low and different according to the tumor location.”

“Therefore, programmatic and repeated screening by immunochemical fecal occult blood test may be necessary to increase sensitivity for colorectal cancer detection.”

Gastroenterol 2005: 129(2): 422-8
10 August 2005

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