A quantitative immunochemical faecal occult blood test is more efficient for detecting significant colorectal neoplasia than a sensitive guaiac test
Article first published online: 7 APR 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 9, pages 1359–1364, May 2006
How to Cite
LEVI, Z., HAZAZI, R., ROZEN, P., VILKIN, A., WAKED, A. and NIV, Y. (2006), A quantitative immunochemical faecal occult blood test is more efficient for detecting significant colorectal neoplasia than a sensitive guaiac test. Alimentary Pharmacology & Therapeutics, 23: 1359–1364. doi: 10.1111/j.1365-2036.2006.02898.x
- Issue published online: 7 APR 2006
- Article first published online: 7 APR 2006
- Publication data Submitted 20 January 2006 First decision 1 February 2006 Resubmitted 13 February 2006 Accepted 22 February 2006
Vol. 24, Issue 5, 895, Article first published online: 16 AUG 2006
The sensitive guaiac faecal occult blood test, Haemoccult SENSA (HOS; Beckman Coulter, Fullerton, CA, USA), is our standard screening test for significant colorectal neoplasia. We evaluated an automatically-developed, quantified human haemoglobin immunochemical faecal test, OC-MICRO (Eiken Chemical Co., Tokyo, Japan), to improve test specificity and so reduce the colonoscopy burden.
To compare guaiac faecal occult blood test and immunochemical faecal test diagnostic efficacy and costs for identifying significant neoplasia.
Colonoscopies were performed on patients who prepared three daily guaiac faecal occult blood tests with or without immunochemical faecal tests.
Total colonoscopy was performed on 151 subjects who prepared both guaiac and immunochemical faecal tests (group 1) and the positive predictive values (PPV) were also compared to those of 162 subjects undergoing colonoscopy for positive guaiac faecal occult blood tests (group 2). In group 1, comparative sensitivity, specificity, and PPVs for significant neoplasia with guaiac faecal occult blood test were 75%, 34%, and 12% (PPV, 18% for group 2) and with immunochemical faecal test were 75%, 94% and 60% (P < 0.01 for specificity). The number of colonoscopy examinations needed to detect a significant neoplasm because of positive faecal occult blood tests was six to eight with HOS and two with OC-MICRO at 21–31% the cost of evaluating a positive guaiac faecal occult blood test.
An immunochemical faecal test maintains the high sensitivity of guaiac faecal occult blood test, but significantly reduces the colonoscopy burden and screening costs.