title: A retrospective study of immunochemical fecal occult blood testing for colorectal cancer detection.
abstract: BACKGROUND
  Colonoscopic examination is the common pathway for positive screening tests detecting colorectal lesions. We evaluated a specific, quantitative high-throughput automatic immunochemical fecal occult blood test (Auto iFOBT) method for colorectal cancer (CRC) screening and to determine its concordance with physician assessments informed by complete colonoscopy, the gold-standard technique for evaluation of the colonic mucosa.
  
  
  METHODS
  1200 CRC symptomatic patients were recruited for a retrospective investigation. Colorectal neoplasia were localized by colonoscopy and cancer outcomes were enumerated according to severity. In addition, stool samples were collected and analyzed by Auto iFOBT to derive sensitivity, specificity, and positive predictive value. Qualitative colonoscopy and Auto iFOBT results were correlated, as were cancer severities and quantitative hemoglobin concentrations.
  
  
  RESULTS
  Ninety-one patients were found positive for CRC; 50 mucosal, 20 submucosal, and 21 advanced. At standard cutoff, sensitivity was 60%, 90%, and 95%, respectively. Specificity and positive predictive value for all neoplasia and cancers were 89.6% and 86.4%, and 60.9% and 33.7%, respectively. Cancer severities could be approximated roughly according to hemoglobin concentrations.
  
  
  CONCLUSIONS
  Specific qualitative 2-day Auto iFOBT is an accurate tool for the detection of colorectal cancer and therefore provides the basis for a large-scale screening program.
authors.affiliation: Department of Gastroenterology, National Cancer Center Hospital East, Chiba, Japan. doc2adova@yahoo.co.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oono
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Iriguchi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Doi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tomino
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kishi
authors.forename: Johji
authors.initials: J
authors.lastname: Oda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takayanagi
authors.forename: Masaru
authors.initials: M
authors.lastname: Mizutani
authors.forename: Tadashi
authors.initials: T
authors.lastname: Fujisaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yamamura
authors.forename: Tozo
authors.initials: T
authors.lastname: Hosoi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Taguchi
authors.forename: Mieko
authors.initials: M
authors.lastname: Kosaka
authors.forename: Pabel
authors.initials: P
authors.lastname: Delgado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000378:metabolism / Q000473:pathology; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D012189:Retrospective Studies