Effectiveness of the immunofecal occult blood test for colorectal cancer screening in a large population.
BACKGROUND
Guaiac tests are the most widely used tests to detect colorectal cancer (CRC). However, their sensitivity is relatively low and results may be affected by various factors. Immunofecal occult blood test (IFOBT) is specific for human hemoglobin and does not require dietary restrictions.


OBJECTIVE
The aim of this study was to evaluate the effectiveness of IFOBT for the screening of precancerous lesions and CRC.


METHODS
From July 2006 to June 2007, IFOBT was performed on 5,919 adults who received periodic health examinations in our hospital. The positive cases were examined by colonoscopy and a double-contrast barium enema. Diagnosis was confirmed by histopathological analysis.


RESULTS
Positive IFOBT was detected in 314 of 5,919 cases (5.30%). Further examinations were made in 264 IFOBT-positive cases. Of these, 116 cases with colorectal cancer (16 cases) or precancerous lesions (94 cases with colorectal adenomatous polyps and 6 cases with active ulcerative colitis) were detected. The total detection rate of CRC and precancerous lesions was 43.94% (116/264). TNM classification of 16 CRC cases was as follows: TNM I in eight cases (50.00%), TNM II in seven cases (43.75%) and TNM III in one case (6.25%), indicating IFOBT can detect CRC in the early stages.


CONCLUSIONS
Regular IFOBT can detect precancerous lesions and CRC in early stages and can thus reduce mortality from CRC.
Yang
Haiyun
H
Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China.
Ge
Zhizheng
Z
Dai
Jun
J
Li
Xiaobo
X
Gao
Yunjie
Y
D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods*; D005243:Feces; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Lancet. 1996 Nov 30;348(9040):1467-71
8942774
Am J Gastroenterol. 2005 Jun;100(6):1393-403
15929776
Am J Gastroenterol. 2009 Jan;104(1):149-53
19098863
Ann Oncol. 2002 Jan;13(1):57-60
11863112
Prev Med. 1994 May;23(3):309-13
8078851
J Med Screen. 2002;9(3):99-103
12370319
Am J Gastroenterol. 2005 Nov;100(11):2519-25
16279909
J Natl Cancer Inst. 1997 Oct 1;89(19):1406-22
9326910
Gut. 2003 Mar;52(3):321-2
12584209
Cancer Epidemiol Biomarkers Prev. 2004 Apr;13(4):654-7
15066933
Ann Oncol. 2002 Jan;13(1):31-4
11863106
Ann Oncol. 2005;16 Suppl 2:ii127-32
15958442
J Clin Gastroenterol. 2006 Nov-Dec;40(10):913-8
17063111
N Engl J Med. 1993 May 13;328(19):1365-71
8474513
J Natl Cancer Inst. 2005 Aug 3;97(15):1107-9
16077063
Ann Oncol. 2002 Jan;13(1):47-50
11863110
Am Fam Physician. 2002 Dec 15;66(12):2287-90
12507168
N Engl J Med. 1992 Mar 5;326(10):658-62
1736104
Ann Oncol. 2002 Jan;13(1):51-6
11863111
Eur J Cancer Prev. 2004 Feb;13(1):71-5
15075791
CA Cancer J Clin. 2006 Jan-Feb;56(1):11-25; quiz 49-50
16449183
J Natl Cancer Inst. 2002 Aug 7;94(15):1126-33
12165637
Ann Oncol. 2002 Jan;13(1):44-6
11863109
CA Cancer J Clin. 2003 Jan-Feb;53(1):44-55
12568443
Aliment Pharmacol Ther. 2006 May 1;23(9):1359-64
16629942
Lancet. 1996 Nov 30;348(9040):1472-7
8942775