Can quantification of faecal occult blood predetermine the need for colonoscopy in patients at risk for non-syndromic familial colorectal cancer?

Autor:	Zohar Levi, Rachel Hazazi, Amal Waked, Paul Rozen, Alexander Vilkin, Shlomo Birkenfeld, Eran Maoz, Yaron Niv
Rok vydání:	2006
Předmět:	Male medicine.medical_specialty Colorectal cancer Population Colonoscopy Gastroenterology Risk Assessment Hemoglobins Predictive Value of Tests Positive predicative value Internal medicine Medicine Blood test Humans Mass Screening Pharmacology (medical) Risk factor Prospective cohort study education Aged Retrospective Studies education.field_of_study Hepatology medicine.diagnostic_test business.industry Cancer Middle Aged medicine.disease Occult Blood Female business Colorectal Neoplasms
Zdroj:	Alimentary pharmacologytherapeutics. 24(10)
ISSN:	0269-2813
Popis:	SUMMARYBackgroundPatients at risk for non-syndromic (Lynch or polyposis) familial colorectalneoplasia undergo colonoscopic surveillance at intervals determined byclinically ascertained protocols. The quantitative immunochemical faecaloccult blood test for human haemoglobin is specific and sensitive for sig-nificant colorectal neoplasia (cancer or advanced adenomatous polyp).AimTo determine immunochemical faecal occult blood test efficacy for identify-ing significant neoplasia in at-risk patients undergoing elective colonoscopy.MethodsWe retrospectively identified consecutive at-risk patients who providedthree immunochemical faecal occultblood testsbefore colonoscopy. Quan-titative haemoglobin analysis was performed by the OC-MICRO automatedinstrument using the 100 ng Hb/mL threshold to determine positivity.ResultsIn 252 at-risk patients undergoing colonoscopy; five had cancer, 14 anadvanced adenoma and 46 a non-advanced adenoma. The immuno-chemical faecal occult blood test was positive in 31 patients (12.3%).Sensitivity, specificity, positive and negative predictive values for can-cer were: 100%, 90%, 16% and 100%, and for all significant neoplasia:74%, 93%, 45% and 98%. With 88% fewer colonoscopies, all colorectalcancers and 74% of all significant neoplasia would have been identifiedby this one-time immunochemical faecal occult blood test screening.ConclusionsA sensitive, non-invasive, interval screening test might be useful to pre-determine the need for colonoscopy in this at-risk population and min-imize unnecessary examinations. This favourable retrospectiveevaluation will be extended to a prospective study.
Databáze:	OpenAIRE
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