Incidence of faecal occult blood test interval cancers in population-based colorectal cancer screening: a systematic review and meta-analysis

Gut ◽  
2018 ◽  
Vol 68 (5) ◽  
pp. 873-881 ◽  
Author(s):  
Els Wieten ◽  
Eline H Schreuders ◽  
Esmée J Grobbee ◽  
Daan Nieboer ◽  
Wichor M Bramer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Incidence Rate ◽  
Occult Blood ◽  
Incidence Rates ◽  
Cochrane Library ◽  
Average Risk ◽  
Crc Screening ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
Test Result

ObjectiveFaecal immunochemical tests (FITs) are replacing guaiac faecal occult blood tests (gFOBTs) for colorectal cancer (CRC) screening. Incidence of interval colorectal cancer (iCRC) following a negative stool test result is not yet known. We aimed to compare incidence of iCRC following a negative FIT or gFOBT.DesignWe searched Ovid Medline, Embase, Cochrane Library, Science Citation Index, PubMed and Google Scholar from inception to 12 December 2017 for citations related to CRC screening based on stool tests. We included studies on FIT or gFOBT iCRC in average-risk screening populations. Main outcome was pooled incidence rate of iCRCs per 100 000 person-years (p-y). Pooled incidence rates were obtained by fitting random-effect Poisson regression models.ResultsWe identified 7 426 records and included 29 studies. Meta-analyses comprised data of 6 987 825 subjects with a negative test result, in whom 11 932 screen-detected CRCs and 5 548 gFOBT or FIT iCRCs were documented. Median faecal haemoglobin (Hb) positivity cut-off used was 20 (range 10–200) µg Hb/g faeces in the 17 studies that provided FIT results. Pooled incidence rates of iCRC following FIT and gFOBT were 20 (95% CI 14 to 29; I2=99%) and 34 (95% CI 20 to 57; I2=99%) per 100 000 p-y, respectively. Pooled incidence rate ratio of FIT versus gFOBT iCRC was 0.58 (95% CI 0.32 to 1.07; I2=99%) and 0.36 (95% CI 0.17 to 0.75; I2=10%) in sensitivity analysis. For every FIT iCRC, 2.6 screen-detected CRCs were found (ratio 1:2.6); for gFOBT, the ratio between iCRC and screen-detected CRC was 1:1.2. Age below 60 years and the third screening round were significantly associated with a lower iCRC rate.ConclusionA negative gFOBT result is associated with a higher iCRC incidence than a negative FIT. This supports the use of FIT over gFOBT as CRC screening tool.

Screening for colorectal cancer

2002 ◽  
Vol 39 (4) ◽  
pp. 351-365 ◽  
Author(s):  
Bryan J Starkey
Keyword(s):  
Colorectal Cancer ◽  
Screening Method ◽  
Point Mutations ◽  
Occult Blood ◽  
Crc Screening ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
The Uk ◽  
Visualization Techniques ◽  
Stool Analysis

Colorectal cancer (CRC) causes 20 000 deaths per annum in the UK alone. Screening has been shown to reduce mortality but debate exists as to which approach to use. Direct visualization of the colorectum has the advantage that it detects lesions most effectively and is required at less frequent intervals, but the procedure is invasive and at present too costly for screening purposes. Faecal occult blood measurement, despite its limitations, is currently the recommended screening method, with follow-up of positive tests by colonoscopy or other visualization techniques. This strategy has been shown to reduce mortality from CRC by about 20% and screening trials directed towards individuals in the over 50 years age group are underway in the UK and elsewhere. Future developments in CRC screening include colorectal visualization by computed colonography - a less-invasive alternative to colonoscopy. Developments in stool analysis are also occurring. Examination of faecal samples for cellular products derived from neoplasms (e.g. calprotectin) may prove more sensitive and specific than faecal occult blood measurements. In addition, detection of altered DNA in faeces is being investigated by molecular biology techniques. Using a multi-target assay panel to detect point mutations and other neoplasia-associated DNA abnormalities may be an effective strategy for CRC screening in the future.

scholarly journals Diagnostic accuracy of faecal occult blood tests used in screening for colorectal cancer: a systematic review

2007 ◽  
Vol 14 (3) ◽  
pp. 132-137 ◽  
Author(s):  
J A Burch ◽  
K Soares-Weiser ◽  
D J B St John ◽  
S Duffy ◽  
S Smith ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Adult Population ◽  
Occult Blood ◽  
Case Control ◽  
Average Risk ◽  
Case Control Studies ◽  
Faecal Occult Blood ◽  
Blood Tests ◽  
Faecal Occult

Objective: To determine the accuracy of guaiac and immunochemical faecal occult blood tests (FOBTs) for the detection of colorectal cancer in an average-risk screening population. Methods: Fifteen electronic databases, the internet, key journals and reference lists of included studies were searched. We included diagnostic accuracy studies that compared guaiac or immunochemical FOBTs with any reference standard, for the detection of colorectal cancer in an average-risk adult population, with sufficient data to construct a 2 × 2 table. Results: Fifty-nine studies were included. Thirty-three evaluated guaiac FOBTs, 35 immunochemical FOBTs and one evaluated sequential FOBTs. Sensitivities for the detection of all neoplasms ranged from 6.2% (specificity 98.0%) to 83.3% (specificity 98.4%) for guaiac FOBTs, and 5.4% (specificity 98.5%) to 62.6% (specificity 94.3%) for immunochemical FOBTs. Specificity ranged from 65.0% (sensitivity 44.1%) to 99.0% (sensitivity 19.3%) for guaiac FOBTs, and 89.4% (sensitivity 30.3%) to 98.5% (sensitivity 5.4%) for immunochemical FOBTs. Diagnostic case–control studies generally reported higher sensitivities. Sensitivities were higher for the detection of CRC, and lower for adenomas, in both the diagnostic cohort and diagnostic case–control studies for both guaiac and immunochemical FOBTs. Conclusions Immudia HemSp appeared to be the most accurate immunochemical FOBT, however, there was no clear evidence to suggest whether guaiac or immunochemical FOBTs performed better, either from direct or indirect comparisons. Poor reporting of data limited the scope of this review, and the use the Standards for Reporting of Diagnostic Accuracy guidelines is recommended for reporting future diagnostic accuracy studies.

Adherence to and predictors of participation in colorectal cancer screening with faecal occult blood testing in Spain, 2009–2011

2015 ◽  
Vol 24 (4) ◽  
pp. 305-312 ◽  
Author(s):  
Isa Ricardo-Rodrigues ◽  
Rodrigo Jiménez-García ◽  
Valentín Hernández-Barrera ◽  
Pilar Carrasco-Garrido ◽  
Isabel Jiménez-Trujillo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Occult Blood ◽  
Faecal Occult Blood Testing ◽  
Blood Testing ◽  
Faecal Occult Blood ◽  
Faecal Occult

scholarly journals Exploring the Barriers Toward Colorectal Cancer Screening: A Literature Review

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Rolla Hamdan ◽  
Jessie Johnson ◽  
Maryam Fatemi ◽  
Kathleen Benjamin ◽  
Afrah Moosa
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Blood Test ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Primary Health ◽  
Faecal Occult ◽  
Bowel Cancer Screening

Background: Colorectal cancer is the third most common cancer and the second leading cause of death worldwide. Bowel cancer screening helps prevent colon cancer by early detection of polyps, leading to efficient treatment and reduced mortality. Within Qatar, primary health facilities promote bowel screening by using the faecal occult blood test. However, the popularity and use of this test is still low. Aim: The aim of this literature review is to explore barriers related to colorectal cancer bowel screening using the faecal occult blood test in primary health care settings to facilitate colorectal cancer screening in Qatar. Method: Cronin’s five step framework for literature reviews was utilized for this paper. This review included nine articles that were peer-reviewed and published between 2009 and 2019. The nine articles were appraised by using the Mixed Methods Appraisal Tool. This tool has separate criteria to assess the quality of the qualitative, quantitative, and mixed-method studies. Result: Three main barriers to bowel cancer screening included knowledge deficit, personal beliefs and organizational barriers. Conclusion: The main barriers are related to the patients’ lack of knowledge and personal beliefs. Overcoming these barriers is essential to raising awareness about this issue among all nurses, physicians, and patients. It is necessary to involve stakeholders in order to mitigate barriers. Developing educational activities for healthcare professionals will provide information that they can share with patients to encourage screening and decrease the fear of the test. Developing a pamphlet to increase patient awareness will also encourage screening and work toward decreasing fear. Key words: faecal occult blood test, faecal immunochemical test, barriers

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