Fecal occult blood test screening for colorectal cancer.
Fecal occult blood test screening for colorectal cancer.
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DOI：
10.1016/s1052-5157(03)00054-0
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发表时间：
2002-01-01
影响因子：
--
通讯作者：
Bond, John H
中科院分区：
文献类型：
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作者：
Bond, John H
总之，高质量的科学研究表明，使用FOBT进行结直肠癌筛查具有许多重要的优势。该测试能够检测大多数早期结直肠癌和许多晚期腺瘤。在随机对照试验中，它已被证明可以大大降低结直肠癌的死亡率和发病率。FOBT是可行的，广泛可用的，并为大多数人所接受。它的前期成本低，成本效益高。每年一次的FOBT与定期的乙状结肠镜检查相结合似乎是一种特别有效的筛查选择。FOBT筛查的局限性包括其对息肉的敏感性低，特别是较小的息肉。一些试验报告了检测位于远端结肠的癌症的相对较低的灵敏度。该测试具有相对较低的特异性，因此有许多假阳性筛选;为了使其最有效，重复筛选是必要的。权衡这些优点和缺点，循证筛查指南得出结论，FOBT筛查在结直肠癌控制中发挥着重要作用，每年一次的FOBT加上每5年一次的乙状结肠镜检查是筛查无症状、平均风险人群结直肠癌的首选方案。由于没有对整个高危人群进行直接结肠镜筛查，FOBT目前是识别无症状、平均风险人群的最佳方法，最有可能从结肠镜检查中获益。
In summary, high-quality scientific studies indicate that the use of the FOBT for colorectal cancer screening has a number of important advantages. The test is capable of detecting most early colorectal cancers and many advanced adenomas. It has been shown in randomized, controlled trials to reduce substantially colorectal cancer mortality and incidence. The FOBT is feasible, widely available, and acceptable to most individuals. It has a low up-front cost and is highly cost-effective. Combining annual FOBT with periodic flexible sigmoidoscopy seems to be an especially effective screening option. Limitations of FOBT screening include its low sensitivity for polyps, especially smaller ones. Some of the trials report a relatively low sensitivity for detecting cancers located in the distal colon. The test has a relatively low specificity, so there are many false-positive screens; and for it to be most effective, repetitive screening is necessary. Balancing these advantages and disadvantages, the evidence-based screening guidelines have concluded that FOBT screening has a major role to play in colorectal cancer control and a program of annual FOBT plus flexible sigmoidoscopy every 5 years is a preferred option for screening the asymptomatic, average-risk population for colorectal cancer. Short of doing direct colonoscopy screening for the entire at-risk population, the FOBT currently is the best available method of identifying asymptomatic, average-risk people most likely to benefit from colonoscopy.