Cancer Res Treat.  2005 Feb;37(1):20-23.

Single Immunochemical Fecal Occult Blood Test for Detection of Colorectal Neoplasia

Affiliations
  • 1Research Institute and Hospital, National Cancer Center, Goyang, Korea. park@ncc.re.kr

Abstract

PURPOSE
This study was designed to investigate the validity of a single immunochemical fecal occult blood test (FOBT) for detection of colorectal neoplasia. MATERIALS AND METHODS: A total of 3, 794 average-risk screenees and 304 colorectal cancer patients admitted to the National Cancer Center, Korea, between May 2001 and November 2002, were studied prospectively. All screenees and admitted patients underwent FOBT and total colonoscopic examinations. Stools were self-collected, and examined using an immunochemical fecal occult blood test (OC-hemodia(R), Eiken Chemical Co. Tokyo, Japan) and an OC-sensor analyzer(R) (Eiken Chemical Co. Tokyo, Japan). RESULTS: Of the 3, 794 asymptomatic screenees, the colonoscopy identified colorectal adenomas and cancers in 613 (16.2%) and 12 (0.3%) subjects, respectively. The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The false positive rate of FOBT for colorectal cancer in screenees was 1.19%. For the total 316 colorectal cancer cases (including 12 cases from screenees), the FOBT sensitivities according to the T-stage were 38.5, 75.0%, 78.9 and 79.2% for T1, 2, 3 and 4 cancers, respectively. The sensitivities according to the Dukes stages A, B and C were 63.4, 79.3 and 78.6%, respectively. CONCLUSION: The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The sensitivities of FOBT were about 80% for Dukes B or C colorectal cancers and 63.4% for Dukes A.

Keyword

Fecal occult blood test; Screening; Colorectal neoplasm; Stage

MeSH Terms

Adenoma
Colonoscopy
Colorectal Neoplasms
Humans
Korea
Mass Screening
Occult Blood*
Prospective Studies

Reference

1. Wilmink AB. Overview of the epidemiology of colorectal cancer. Dis Colon Rectum. 1997; 40:483–493. PMID: 9106701.
Article
2. Shin HR, Ahn YO, Bae JM, Shin MH, Lee DH, Lee CW, et al. Cancer incidence in Korea. Cancer Res Treat. 2002; 34:405–408.
Article
3. Park YJ, Youk EG, Choi HS, Park KJ, Lee KU, Choe KJ, et al. Experience of 1,446 rectal cancer patients in Korea and analysis of prognostic factors. Int J Colorectal Dis. 1999; 14:101–106. PMID: 10367255.
Article
4. Citarda F, Tomaselli G, Capocaccia R, Barcherini S, Crespi M. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut. 2001; 48:812–815. PMID: 11358901.
Article
5. Mandel JS, Church TR, Bond JH, Ederer F, Geisser MS, Mongin SJ, et al. The effect of fecal occult-blood screening on incidence of colorectal cancer. N Engl J Med. 2000; 343:1603–1607. PMID: 11096167.
6. Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993; 328:1365–1371. PMID: 8474513.
7. Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with fecal occult blood test. Lancet. 1996; 348:1467–1471. PMID: 8942774.
8. Hardcastle JD, Chamberlain J, Robinson MH, Moss SM, Amar SS, Balfour TW, et al. Randomised controlled trial of fecaloccult-blood screening for colorectal cancer. Lancet. 1996; 348:1472–1477. PMID: 8942775.
9. Allison JE, Tekawa IS, Ransom LJ, Adrain AL. A comparison of fecal occult-blood tests for colorectal cancer screening. N Engl J Med. 1996; 334:155–159. PMID: 8531970.
10. Nakama H, Kamijo N, Miyata K, Abdul Fattah AS, Zhang B, Uehara Y. Sensitivity and specificity of several immunochemical tests for colorectal cancer. Hepato-gastroenterolog. 1998; 45:1579–1582.
11. Dukes CE. The classification of cancer of the rectum. J Pathol Bacteriol. 1932; 35:323.
Article
12. Smith RA, von Eschenbach AC, Wender R, Levin B, Byers T, Rothenberger D, et al. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001- testing for early lung cancer detection. CA Cancer J Clin. 2001; 51:38–75. PMID: 11577479.
13. Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A. Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology. Am J Gastroenterol. 2000; 95:868–877. PMID: 10763931.
Article
14. Vijan S, Hwang EW, Hofer TP, Hayward RA. Which colon cancer screening test? A comparison of costs, effectiveness, and compliance. Am J Med. 2001; 111:593–601. PMID: 11755501.
Article
15. Rozen P, Knaani J, Samuel Z. Comparative screening with a sensitive guaiac and specific immunochemical occult blood test in an endoscopic study. Cancer. 2000; 89:46–52. PMID: 10896999.
Article
16. Lieberman DA, Weiss DG. One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med. 2001; 345:555–560. PMID: 11529208.
Article
17. Nakama H, Yamamoto M, Kamijo N, Li T, Wei N, Fattah AS, et al. Colonoscopic evaluation of immunochemical fecal occult blood test for detection of colorectal neoplasia. Hepato gastroenterology. 1999; 46:228–231. PMID: 10228797.
18. Yoshinaga M, Motomura S, Takeda H, Yanagisawa Z, Ikeda K. Evaluation of the sensitivity of an immunochemical fecal occult blood test for colorectal neoplasia. Am J Gastroenterol. 1995; 90:1076–1079. PMID: 7611200.
19. Lee BI, Choi KY, Bae SS, Kim BW, Choi H, Park SH, et al. Factors of colorectal cancer and adenoma affecting immunological fecal occult blood test. Korean J Gastroenterol. 2001; 37:428–435.
20. Schwartz S, Ellefson M. Quantitative fecal recovery of ingested hemoglobin-heme in blood: Comparisons by HemoQuant assay with ingested meat and fish. Gastroenterology. 1985; 89:19–26. PMID: 4007402.
Article
21. Nakama H, Zhang B, Zhang X. Evaluation of the optimum cut-off point in immunochemical occult blood testing in screening for colorectal cancer. Eur J Cancer. 2001; 37:398–401. PMID: 11239763.
Article
22. Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993; 329:1977–1981. PMID: 8247072.
Article
23. Kim SW, Park JG, Kim JP. Multiple primary colorectal cancer. J Korean Cancer Assoc. 1985; 17:94–102.
24. Ransohoff DF, Lang CA. Using colonoscopy to screen for colorectal cancer. Am J Gastroenterol. 1994; 89:1765–1766. PMID: 7942662.
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