Diagnostic accuracy of a single qualitative immunochemical fecal occult blood test coupled with physical measurements.

Taiyin WU; Kuanliang Kuo; Yifan WU; Kuangyang Lin

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Diagnostic accuracy of a single qualitative immunochemical fecal occult blood test coupled with physical measurements.

Author: Taiyin WU ^{1
,

2} ; Kuanliang KUO ³ ; Yifan WU ¹ ; Kuangyang LIN ³
Author Information

1. Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan, China
2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, China.
3. Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei, Taiwan, China.
Publication Type:Journal Article
MeSH: Adult; Aged; Aged, 80 and over; Colorectal Neoplasms; diagnosis; Female; Humans; Male; Mass Screening; Middle Aged; Occult Blood; Sensitivity and Specificity; Young Adult
From: Chinese Medical Journal 2014;127(24):4164-4170
CountryChina
Language:English
Abstract:
BACKGROUNDWe aimed to improve the sensitivity of immunochemical fecal occult blood test (I-FOBT) to screen colorectal neoplasm among average-risk adults.
METHODSThis is a diagnostic cohort study. All health examination participants receiving a single qualitative I-FOBT and a screening colonoscopy from January 2010 to June 2011 were included. Stool specimens were collected for I-FOBT before colonoscopy. Using pathology as gold standard, significant colorectal neoplasm was defined as advanced adenoma or malignancy.
RESULTSA total of 1 007 health examinees were identified. Fifty-five (5.5%) had borderline positive (+/-) I-FOBT, while 38 (3.8%) had positive I-FOBT. Twenty-four (2.4%) had advanced adenoma, and five (0.5%) had carcinoma. Using borderline positive I-FOBT as cutoff value, the sensitivity and specificity for significant colorectal neoplasm were 34.5% (95% confidence interval (CI) 19.9%-52.7%) and 91.5% (95% CI 89.6%-93.1%), respectively. If combined with advanced age, high blood pressure (BP), and abdominal obesity, a fulfillment of either two criteria further increased the sensitivity to 72.4% (95% CI 54.3%-85.3%) with a specificity of 68.8% (95% CI 65.8%-71.6%).
CONCLUSIONThe sensitivity of a single qualitative I-FOBT for the detection of significant colorectal neoplasm can be increased by coupling with age, BP, and abdominal obesity.