Colonoscopy‐controlled intra‐individual comparisons to screen relevant neoplasia: faecal immunochemical test vs. guaiac‐based faecal occult blood test |
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| Authors: | F. A. OORT J. S. TERHAAR SIVE DROSTE R. W. M. VAN DER HULST H. A. VAN HEUKELEM R. J. L. F. LOFFELD I. C. E. WESDORP R. L. J. VAN WANROOIJ L. DE BAAIJ E. R. MUTSAERS S. VAN DER REIJT V. M. H. COUPE J. BERKHOF A. A. BOUMAN G. A. MEIJER C. J. J. MULDER |
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| Affiliation: | 1. Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands;2. Both authors contributed equally to this work.;3. Department of Gastroenterology and Hepatology, Kennemer Gasthuis, Amsterdam, The Netherlands;4. Department of Gastroenterology and Hepatology, Slotervaart Hospital, Amsterdam, The Netherlands;5. Department of Internal Medicine, Zaans Medical Center, Zaandam, The Netherlands;6. Department of Gastroenterology and Hepatology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands;7. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands;8. Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands;9. Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands |
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| Abstract: | Aliment Pharmacol Ther 31 , 432–439 Summary Background Guaiac‐based faecal occult blood tests (g‐FOBTs) are most commonly used in colorectal cancer (CRC) screening programmes. Faecal immunochemical tests (FITs) are thought to be superior. Aim To compare performance of a g‐FOBT and a quantitative FIT for detection of CRCs and advanced adenomas in a colonoscopy‐controlled population. Methods We assessed sensitivity and specificity of both FIT (OC‐sensor) and g‐FOBT (Hemoccult‐II) prior to patients’ scheduled colonoscopies. Results Of the 62 invasive cancers detected in 1821 individuals, g‐FOBT was positive in 46 and FIT in 54 (74.2% vs. 87.1%, P = 0.02). Among 194 patients with advanced adenomas, g‐FOBT was positive in 35 and FIT in 69 (18.0% vs. 35.6%, P < 0.001). Sensitivity for screen relevant tumours (197 advanced adenomas and 28 stage I or II cancers) was 23.0% for g‐FOBT and 40.5% for FIT (P < 0.001). Specificity of g‐FOBT compared to FIT for the detection of cancer was 95.7% vs. 91.0%, P < 0.001) and for advanced adenomas (97.4% vs. 94.2%, P < 0.001). Conclusions Faecal immunochemical test is more sensitive for CRC and advanced adenomas. Sensitivity of FIT for screen relevant tumours, early‐stage cancers and advanced adenomas, is significantly higher. Specificity of g‐FOBT is higher compared with FIT. |
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