Is a fecal occult blood test a useful tool for judging whether to perform capsule endoscopy in low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy?
| Autor: | Atsushi Nakajima, Hiroki Endo, Jun Arimoto, Masataka Taguri, Hidenori Ohkubo, Yasuo Hata, Takashi Sakaguchi, Takashi Nonaka, Masahiko Inamori, Takeharu Yamanaka, Takuma Higurashi, Hajime Nagase, Takayuki Kato, Eiji Sakai, Harunobu Kawamura, Leo Taniguchi |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Colonoscopy Capsule Endoscopy Sensitivity and Specificity Gastroenterology law.invention 03 medical and health sciences 0302 clinical medicine Japan Predictive Value of Tests Capsule endoscopy law Internal medicine Humans Medicine Endoscopy Digestive System Prospective Studies 030212 general & internal medicine Aged Aged 80 and over Aspirin medicine.diagnostic_test business.industry Esophagogastroduodenoscopy Immunochemistry Fecal occult blood Anemia Middle Aged medicine.disease Colorectal surgery Occult Blood Predictive value of tests Female 030211 gastroenterology & hepatology Colorectal Neoplasms business medicine.drug |
| Zdroj: | Journal of Gastroenterology. 52:194-202 |
| ISSN: | 1435-5922 0944-1174 |
| Popis: | Aspirin use is reportedly not to be associated with fecal immunochemical occult blood test (FIT) false-positive results for the detection of colorectal cancer. The need for additional small bowel exploration in FIT-positive, low-dose aspirin users with a negative colonoscopy is controversial. The aim of this study was to assess the ability of FIT to judge whether capsule endoscopy (CE) should be performed in low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy findings by comparing FIT results with CE findings. A total of 264 consecutive low-dose aspirin users with negative colonoscopy and esophagogastroduodenoscopy who were scheduled to undergo CE at five hospitals in Japan were enrolled. Patients had been offered FIT prior to the CE. The association between the FIT results and the CE findings was then assessed. One hundred and fifty-seven patients were included in the final analysis. Eighty-four patients (53.5 %) had positive FIT results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of positive FIT results for small bowel ulcers were 0.56, 0.47, 0.30, and 0.73, respectively. Furthermore, the NPV of positive FIT results for severe small bowel injury (Lewis score ≥790) was markedly high (0.90). When the analysis was performed only in low-dose aspirin users with anemia, the sensitivity of the positive FIT results was notably improved (0.72). Small bowel evaluation using CE is not recommended for FIT-negative, low-dose aspirin users. However, small bowel evaluation using CE should be considered in both FIT-positive and anemic low-dose aspirin users. |
| Databáze: | OpenAIRE |
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