Sensitivity of Two-Time Immunochemical Fecal Occult-Blood Testing with Sigmoidoscopy for the Detection of Advanced Colon Adenoma.
- Author:
Ki Tae SUK
1
;
Hyun Soo KIM
;
Jung Kwon KIM
;
Jung Min KIM
;
Myeong Gwan JEE
;
Sang Won JI
;
Soon Koo BAIK
;
Dong Ki LEE
;
Sang Ok KWON
Author Information
1. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. hskim@wonju.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Advanced colon adenoma;
Sigmoidoscopy;
Fecal occult blood test;
Screening
- MeSH:
Adenoma*;
Agglutination;
Colon*;
Colonoscopy;
Colorectal Neoplasms;
Diagnosis;
Humans;
Latex;
Mass Screening;
Occult Blood;
Polyps;
Sigmoidoscopy*
- From:Korean Journal of Gastrointestinal Endoscopy
2004;28(6):291-297
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Because detection and removal of colonic adenoma provided an opportunity to prevent colorectal cancer, advanced adenoma (>10 mm, villous or high grade dysplasia) should be the major target of screening. In this study, we assessed the diagnostic sensitivity of one- or two-time immunochemical fecal occult blood test (i-FOBT), flexible sigmoidoscopy and their combination in patients with advanced adenoma or non-advanced adenoma. MEHTODS: From January to October 2002, we performed colonoscopy with i-FOBT using latex agglutination method in 879 individuals. Among these, we diagnosed 234 polyps in 93 patients with advanced adenoma and 179 polyps in 109 patients with non-advanced adenoma. After the diagnosis of adenoma, second i-FOBT was done before polypectomy. Based on these data, we evaluated the diagnostic sensitivities of i-FOBT, flexible sigmoidoscopy and their combination for patients with advanced adenoma or non-advanced adenoma. RESULTS: The diagnostic sensitivity of one- or two-time i-FOBT, flexible sigmoidoscopy and flexible sigmoidoscopy with two-time i-FOBT in patients with advanced adenoma vs.non-advanced adenoma were 17.2% vs. 18.3%, 28.0% vs. 29.4%, 70.1% vs. 66.1% and 81.7% vs. 78.0%. Although repeated application of i-FOBT enhanced diagnostic sensitivity for colon adenoma, this test or combination with flexible sigmoidoscopy did not differentiate advanced adenoma from non-advanced adenoma. CONCLUSIONS: Although it fails to detect one fifth of colon adenoma, combined two-time i-FOBT testing with flexible sigmoidoscopy is an effective and feasible screening modality for advanced colon adenoma.
