Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang-si, Korea ; Cancer Registration & Statistics Branch, National Cancer Control Institute, National Cancer Center, Goyang-si, Korea.
PLoS One. 2013 Nov 8;8(11):e79292. doi: 10.1371/journal.pone.0079292. eCollection 2013.
The aims of the current study were to assess the validity of the fecal occult blood test (FOBT) in an organized screening setting in Korea and to determine factors associated with FOBT validity, such as screening round, age group, and anatomical location of the cancer.
Study participants were those who were 50 years and older who received an FOBT through the National Cancer Screening Program between 2004 and 2007. Colorectal cancer diagnoses were ascertained through linkage with the Korean National Cancer Incidence Database. The positivity rate, colorectal cancer detection rate, interval cancer rate, sensitivity, specificity, and positive predictive value of the FOBT were calculated.
A total of 2,193,093 tests were included in the analysis. Overall, the sensitivity of the FOBT for colorectal cancer was 59.7% for the first round and 56.1% for the subsequent round. Sensitivity was highest for distal colon cancer (65.9%) in the first round, and for rectal cancer (58.4%) for the subsequent round. The sensitivity and positive predictive value of the FOBT generally improved between 2004 and 2008.
The FOBT showed reasonable validity in an organized screening setting, and the validity of the FOBT varied by screening round, anatomical location, and screening year.
本研究旨在评估在韩国有组织的筛查环境中粪便潜血试验（FOBT）的有效性，并确定与 FOBT 有效性相关的因素，如筛查轮次、年龄组和癌症的解剖位置。
研究对象为 2004 年至 2007 年间通过国家癌症筛查计划接受 FOBT 的 50 岁及以上人群。通过与韩国国家癌症发病率数据库的链接确定结直肠癌的诊断。计算 FOBT 的阳性率、结直肠癌检出率、间期癌率、敏感性、特异性和阳性预测值。
共纳入 2193093 例检测。总体而言，FOBT 对结直肠癌的敏感性在第一轮为 59.7%，第二轮为 56.1%。第一轮时，远端结肠癌（65.9%）和第二轮时，直肠（58.4%）的敏感性最高。FOBT 的敏感性和阳性预测值在 2004 年至 2008 年间普遍提高。
FOBT 在有组织的筛查环境中具有合理的有效性，FOBT 的有效性因筛查轮次、解剖位置和筛查年份而异。
