Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242 Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242
Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242 Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242.
J Med Screen. 2014 Sep;21(3):133-43. doi: 10.1177/0969141314541109. Epub 2014 Jun 23.
Faecal occult blood tests are often the initial test in population-based screening. We aimed to: 1) compare the results of single sample faecal immunochemical tests (FITs) with colonoscopy, and 2) calculate the sensitivity for proximal vs. distal adenomatous polyps or cancer.
Individuals scheduled for a colonoscopy were invited to complete a FIT prior to their colonoscopy preparation. FIT results were classified as positive, negative, or invalid. Colonoscopy reports were reviewed and abstracted. Because of product issues, four different FIT manufacturers were used. The test characteristics for each FIT manufacturer were calculated for advanced adenomatous polyps or cancer according to broad reason for colonoscopy (screening or surveillance/diagnostic).
Of those invited, 1,026 individuals (43.9%) completed their colonoscopy and had a valid FIT result. The overall sensitivity of the FITs (95% confidence intervals) was 0.18 (0.10 to 0.28) and specificity was 0.90 (0.87 to 0.91) for advanced adenomas or cancer. The sensitivity for distal lesions was 0.23 (0.11 to 0.38) and for proximal lesions was 0.09 (0.02 to 0.25). The odds ratio of an individual with a distal advanced adenoma or cancer testing positive was 2.68 (1.20 to 5.99). The two individuals with colorectal cancer tested negative, as did one individual with high-grade dysplasia.
The sensitivity of a single-sample FIT for advanced adenomas or cancer was low. Individuals with distal adenomas had a higher odds of testing positive than those with proximal lesions or no lesions.
粪便潜血试验常用于人群筛查的初始检测。我们的目的是：1）比较单次粪便免疫化学检测（FIT）与结肠镜检查的结果，2）计算近端与远端腺瘤性息肉或癌症的敏感性。
预约结肠镜检查的个体被邀请在结肠镜检查准备前完成 FIT。FIT 结果分为阳性、阴性或无效。审查并摘录结肠镜检查报告。由于产品问题，使用了四个不同的 FIT 制造商。根据结肠镜检查的广泛原因（筛查或监测/诊断），为每个 FIT 制造商计算了用于高级腺瘤性息肉或癌症的测试特征。
受邀者中有 1026 人（43.9%）完成了结肠镜检查并获得了有效的 FIT 结果。FIT 的总体敏感性（95%置信区间）为 0.18（0.10 至 0.28），特异性为 0.90（0.87 至 0.91），用于高级腺瘤或癌症。远端病变的敏感性为 0.23（0.11 至 0.38），近端病变的敏感性为 0.09（0.02 至 0.25）。远端高级腺瘤或癌症患者检测阳性的个体的优势比为 2.68（1.20 至 5.99）。两名结直肠癌患者检测结果为阴性，一名高级别异型增生患者也是如此。
单次样本 FIT 对高级腺瘤或癌症的敏感性较低。远端腺瘤患者检测阳性的几率高于近端病变或无病变患者。
