Screening for colorectal cancer - A comparison of 3 fecal occult blood tests
Screening for colorectal cancer - A comparison of 3 fecal occult blood tests
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DOI：
10.1001/archinte.157.9.970
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发表时间：
1997-05-12
影响因子：
--
通讯作者：
Johnson, C
中科院分区：
文献类型：
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作者：
Levin, B;Hess, K;Johnson, C
背景：结直肠癌是美国癌症死亡的第二大原因。粪便隐血检测已成为普通无症状人群中大肠癌的标准筛查试验。测试的性能特征以及医生和参与者的依从性是影响筛查和早期发现成功的两个主要因素。目的：评估非水合隐匿性血液、再水合隐匿性血液和隐匿性血液SENSA试验（SmithKline Diagnostics Inc ., palalto, california），并评估参与者和医生的依从性。方法：在城市环境中进行大规模社区筛查研究。工具包由当地药房和社区站点分发。诊断测试通过医生办公室和诊所完成。参与者无症状，年龄在50岁或以上。那些检测呈阳性的人被建议去看医生。结果：8293试剂盒总阳性率为16%。再水合隐匿血阳性率为15%；血隐性SENSA， 7%；非水合潜血，5%。非水合潜血阳性预测值为14%；再水合潜血，7%；血液隐秘性SENSA占11%。在检测呈阳性的患者中，59%的患者在随访时进行了结肠镜检查或乙状结肠镜检查和双对比钡灌肠检查。对于那些咨询了胃肠病学家的人，建议进行更频繁的随访。结论：与潜血SENSA和非水合潜血相比，再水合潜血的阳性率较高，阳性预测值较低。潜血SENSA接近非水合潜血阳性预测值。粪便隐血检测阳性患者的随访是否充分需要改进。
Background: Colorectal cancer is the second leading cause of cancer deaths in the United States. Fecal occult blood testing has become a standard screening test for large-bowel cancers in the average asymptomatic population. Performance characteristics of the test and physician and participant compliance are the 2 major elements that impact the success of screening and early detection.Objectives: To evaluate the nonhydrated Hemoccult, rehydrated Hemoccult, and Hemoccult SENSA tests (SmithKline Diagnostics Inc, Pale Alto, Calif) and to assess participant and physician compliance.Methods: A mass community-based screening study in an urban setting. Kits were distributed by a local pharmacy and at community sites. Diagnostic tests were completed through physicians' offices and clinics. Participants were asymptomatic and aged 50 years or older. Those who tested positive were advised to follow up with a physician.Results: An overall positivity rate of 16% was reported for the 8293 kits that were processed. Rehydrated Hemoccult had a positivity rate of 15%; Hemoccult SENSA, 7%; and nonhydrated Hemoccult, 5%. The positive predictive value of nonhydrated Hemoccult was 14%; rehydrated Hemoccult, 7%; and Hemoccult SENSA, 11%. Of those who tested positive, 59% had a colonoscopy or flexible sigmoidoscopy and double-contrast barium enema examination on follow-up. Recommended follow-up was more frequent for those who consulted a gastroenterologist.Conclusions: Rehydrated Hemoccult yielded a higher positivity rate and lower positive predictive value than either Hemoccult SENSA or nonhydrated Hemoccult. Hemoccult SENSA approached the positive predictive value of nonhydrated Hemoccult. Adequacy of follow-up of patients testing positive for fecal occult blood needs improvement.