Can patients at high risk for significant colorectal neoplasms and having normal quantitative faecal occult blood test postpone elective colonoscopy?

Alimentary Pharmacology & Therapeutics
R HazaziY Niv

Abstract

Common reasons for elective screening and surveillance colonoscopy, at predetermined intervals, are family or personal history of colorectal cancer (CRC) or advanced adenoma (AAP). Quantified, human haemoglobin (Hb)-specific, immunochemical faecal occult blood tests (I-FOBT) detect bleeding. To determine I-FOBT sensitivity for CRC or AAP before elective colonoscopy in patients at high-risk of cancer or advanced adenoma. Prospective double-blind study of 1000 ambulatory asymptomatic high-risk patients (555 family history of CRC, 445 surveillance for past neoplasm), who prepared three I-FOBTs before elective colonoscopy. I-FOBTs quantified as ngHb/mL of buffer by OC-MICRO instrument and results >or=50 ngHb/mL considered positive. At colonoscopy, eight patients had CRC, 64 others had AAP. Sensitivity for CRC and/or AAP was the highest, 65.3% (95% CI 54.3, 76.3), when any of the three I-FOBTs was >or=50 ngHb (15.4%), with specificity of 87.5% (95% CI 86.4, 90.5) identifying all CRCs and 62% of AAPs. All cancers or an AAP were detected every third I-FOBT-positive colonoscopy (47/154), so colonoscopy was potentially not needed at this time in 84.6% (846 patients). I-FOBT screening might provide effective supervision of high-risk pati...Continue Reading

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Citations

Jul 26, 2012·BMC Gastroenterology·Jochim S Terhaar sive DrosteChris J J Mulder
Jul 21, 2011·World Journal of Clinical Oncology·Oscar J CorderoF Javier Rodriguez-Berrocal
Dec 10, 2013·Gastroenterology Research and Practice·Bianca Rosa Viana FreitasMaria Aparecida Mesquita
Apr 29, 2014·Clinical Biochemistry·Magdalen R R CarrollStephen P Halloran
Dec 3, 2016·Alimentary Pharmacology & Therapeutics·M M WidlakR P Arasaradnam
Mar 11, 2015·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Jaeyoung Chun, Jong Pil Im
Dec 2, 2021·Gastroenterología y hepatología·Gemma Ibáñez-SanzUNKNOWN PhD on behalf of the MSIC-SC research group

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