Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies
Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies
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用于结直肠癌筛查的粪便潜血试验选择：基于人群研究表现特征的建议
DOI：
10.1111/j.1572-0241.2002.06046.x
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发表时间：
2002
影响因子：
9.8
通讯作者：
P. Rozen
中科院分区：
文献类型：
--
作者：
G. Young;James D B St John;S. Winawer;P. Rozen
目的：现在有强有力的证据表明，通过粪便潜血试验（FOBT）筛查结直肠癌可有效降低该疾病的发病率和死亡率。现在有各种 FOBT 可供使用，并有广泛的证据支持其使用。本研究的目的是回顾已发表的有关这些 FOBT 性能的数据，为它们在筛查中的有效使用提供建议。方法：为此研究成立了一个代表世界卫生组织和世界消化内窥镜组织的联合委员会。我们设计了一个流程，系统地搜索文献以寻找 FOBT 表现的证据。本文纳入研究的标准是根据研究设计、队列规模和报告的性能变量制定的。 结果：在愈创木脂测试中，Hemocult SENSA 对癌症和腺瘤的敏感性最高，但测试阳性率也很高。它比旧的 Hemocult II 测试具有更好的可读性。免疫化学测试、HemeSelect、FlexSure OBT 和 Immudia Hem Sp 具有可接受的性能特征，并且更易于参与者使用，但价格更高。这些测试已经在大型队列中进行了深入研究，但只有 Immudia Hem Sp 可以商业化。结论：目前，还没有经过广泛研究的 FOBT 可以满足全球所有目标人群的需求。 FOBT 的选择应考虑人群饮食依从性和结肠镜检查资源：如果饮食依从性良好（在愈创木脂测试的情况下），并且结肠镜检查资源足以对测试呈阳性的人进行诊断检查，则应使用更敏感的新型测试。免疫化学测试消除了饮食和药物限制造成的困难，并且更适合标准化开发和质量控制。
OBJECTIVE:There is now strong evidence that screening for colorectal cancer with fecal occult blood tests (FOBTs) is effective in reducing the incidence and mortality of this disease. Various FOBTs are now available with a wide range of evidence supporting their use. The purpose of this study was to review published data on the performance of these FOBTs to provide recommendations for their effective use in screening.METHODS:A joint committee representing the World Health Organization and the World Organization for Digestive Endoscopy was established for this study. A process was designed that would search the literature systematically for evidence of FOBT performance. Criteria for including studies in this paper were established based on study design, cohort size, and performance variables reported.RESULTS:Of the guaiac tests, Hemoccult SENSA had the highest sensitivity for cancer and adenomas but a high test positivity. It had a better readability than the older Hemoccult II test. Immunochemical tests, HemeSelect, FlexSure OBT, and Immudia Hem Sp have acceptable performance characteristics and are easier for participants to use but are more expensive. These tests have been well studied in large cohorts, but only Immudia Hem Sp is commercially available.CONCLUSIONS:At present, there is no extensively studied FOBT that fulfills the needs for all target populations worldwide. Choice of FOBT should take into account population dietary compliance and colonoscopy resources: The more sensitive newer tests should be used if dietary compliance is good (in the case of guaiac tests) and colonoscopy resources are adequate for diagnostic workup of people who test positive. Immunochemical tests remove the difficulties created by diet and drug restrictions and are more amenable to standardized development and quality control.
影响因子：
158.5
作者：
MANDEL, JS;BOND, JH;EDERER, F
通讯作者：
EDERER, F
影响因子：
158.5
作者：
Mandel, JS;Church, TR;Schuman, LM
通讯作者：
Schuman, LM
影响因子：
158.5
作者：
WINAWER, SJ;ZAUBER, AG;STEWART, ET
通讯作者：
STEWART, ET