Journal articles: 'Faecal occult blood test (FOBT)'

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Yong, Sook Kwin, Whee Sze Ong, Gerald Choon-Huat Koh, Richard Ming Chert Yeo, and Tam Cam Ha. "Colorectal cancer screening: Barriers to the faecal occult blood test (FOBT) and colonoscopy in Singapore." Proceedings of Singapore Healthcare 25, no. 4 (July 31, 2016): 207–14. http://dx.doi.org/10.1177/2010105816643554.

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Introduction: This study aims to identify the barriers to adopting faecal occult blood test (FOBT) and colonoscopy as colorectal cancer (CRC) screening methods among the eligible target population of Singapore. Materials and methods: This study was previously part of a randomised controlled trial reported elsewhere. Data was collected from Singapore residents aged 50 and above, via a household sample survey. The study recruited subjects who were aware of CRC screening methods, and interviewed them about the barriers to screening that they faced. Collected results on barriers to each screening method were analysed separately. Results: Out of the 343 subjects, 85 (24.8%) recruited knew about FOBT and/or colonoscopy. Most of the respondents (48.9%) cited not having symptoms as the reason for not using the FOBT. This is followed by inconvenience (31.1%), not having any family history of colon cancer (28.9%), lack of time (28.9%) and lack of reminders/recommendation (28.9%). Of the respondents who indicated not choosing colonoscopy as a screening method, more than one-half (54.8%) identified not having any symptoms as the main barrier for them, followed by not having any family history (38.7%) and having a healthy/low-risk lifestyle (29.0%). There was no difference between the reported barriers to each of the screening methods and the respondents’ dwelling types. Conclusions: Lack of knowledge, particularly the misconceptions of not having symptoms and being healthy, were identified as the main barriers to FOBT and colonoscopy as screening methods. Interventions to increase the uptake of CRC screening in this population should be tailored to address this misconception.

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Bond, Ashley D., Michael D. Burkitt, David Sawbridge, Bernard M. Corfe, and Chris S. Probert. "Correlation between Faecal Tumour M2 Pyruvate Kinase and Colonoscopy for the Detection of Adenomatous Neoplasia in a Secondary Care Cohort." Journal of Gastrointestinal and Liver Diseases 25, no. 1 (March 1, 2016): 71–77. http://dx.doi.org/10.15403/jgld.2014.1121.251.m2p.

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Background & Aims: Colorectal cancer screening programmes that target detection and excision of adenomatous colonic polyps have been shown to reduce colorectal cancer related mortality. Many screening programmes include an initial faecal occult blood test (FOBt) prior to colonoscopy. To refine the selection of patients for colonoscopy other faecal-based diagnostic tools have been proposed, including tumour M2-pyruvate kinase (tM2-PK). To determine whether tM2-PK quantification may have a role in diverse settings we have assessed the assay in a cohort of patients derived from both the England bowel cancer screening programme (BCSP) and symptomatic individuals presenting to secondary care. Method. Patients undergoing colonoscopy provided faecal samples prior to bowel preparation. Faecal tM2-PK concentrations were measured by ELISA. Sensitivity, specificity, positive predictive value, negative predictive value and ROC analyses were calculated. Results. Ninety-six patients returned faecal samples: 50 of these with adenomas and 7 with cancer. Median age was 68. Median faecal tM2-PK concentration was 3.8 U/mL for individuals without neoplastic findings at colonoscopy, 7.7 U/mL in those with adenomas and 24.4 U/mL in subjects with colorectal cancer (both, p=0.01). ROC analysis demonstrated an AUROC of 0.66 (sensitivity 72.4%, specificity 48.7%, positive predictive value 67.7%, negative predictive value 36.7%). Amongst BCSP patients with a prior positive FOBt faecal tM2-PK was more abundant (median 6.4 U/mL, p=0.03) and its diagnostic accuracy was greater (AUROC 0.82). Conclusion. Our findings confirm that faecal tM2-PK ELISA may have utility as an adjunct to FOBt in a screening context, but do not support its use in symptomatic patients. Abbreviations: BCSP: Bowel cancer screening programme; EMR: Endoscopic mucosal resection; FAP: Familial adenomatous polyposis; FOBt: Faecal occult blood testing; NHS: National Health Service; tM2-PK: tumour M2-pyruvate kinase.

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Lué, Alberto, Gonzalo Hijos, Carlos Sostres, Alba Perales, Mercedes Navarro, Maria Victoria Barra, Barbara Mascialino, et al. "The combination of quantitative faecal occult blood test and faecal calprotectin is a cost-effective strategy to avoid colonoscopies in symptomatic patients without relevant pathology." Therapeutic Advances in Gastroenterology 13 (January 2020): 175628482092078. http://dx.doi.org/10.1177/1756284820920786.

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Background: Faecal occult blood test (FOBT) has demonstrated effectiveness in colorectal cancer (CRC) screening. Faecal calprotectin (FC) has proven efficient for evaluating activity in inflammatory bowel disease (IBD), but its value in CRC detection is less established. Most symptomatic patients have benign pathologies, but still undergo colonoscopy in many settings. Aims: To evaluate the diagnostic accuracy and cost-effectiveness of the combination of FOBT plus FC in symptomatic patients. Methods: Patients who completed colonic investigations and returned stool samples, on which FOBT and FC were performed, were recruited prospectively. CRC, advanced adenoma, IBD and angiodysplasia were considered as relevant pathologies. Results: A total of 404 patients were included, of whom 87 (21.5%) had relevant pathologies. Sensitivity and specificity were 50.6% and 69.6% for FOBT, 78.2% and 54.4% for FC. Negative predictive value (NPV) was 90.1% for FC and 86.9% for FOBT. NPV for the combination of FOBT and FC was 94.1%, with a sensitivity and specificity of 88.5% and 50.3%. The area under ROC (receiver operator curve) (AUC) was 0.741 for FOBT, 0.736 for FC and 0.816 for the combination. The total cost for visits and procedures was €233,016 (€577/patient). Using a combination of FOBT and FC as pre-endoscopic tool allows colonoscopies to be reduced by 39.4%, reducing total costs by 20.5%. Conclusion: The combination of FOBT and FC has a better diagnostic accuracy compared with each test alone. Performing both tests before colonoscopy is a less costly and more effective strategy, reducing unnecessary procedures and complications.

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Pollack, Allan, Doreen Busingye, Jill Thistlethwaite, Suzanne Blogg, and Kendal Chidwick. "Characteristics of patients aged 50–74 years with a request for an immunochemical faecal occult blood test in the Australian general practice setting." Australian Health Review 46, no. 2 (February 28, 2022): 222–32. http://dx.doi.org/10.1071/ah21129.

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Objective To support improving participation in the National Bowel Cancer Screening Program (NBCSP), we aimed to identify Medicare-subsidised test requests for immunochemical faecal occult blood tests (FOBT) in Australian general practice for patients aged 50–74 years, eligible for the NBCSP, and describe sociodemographics, risk factors, indications and outcomes. Methods A cross-sectional study was conducted using de-identified data from 441 Australian general practice sites in the MedicineInsight database, recorded from 1 January 2018 to 31 December 2019. Results Of the 683 625 eligible patients, 45 771 (6.7%) had a record of a general practitioner (GP)-requested FOBT, either to aid diagnosis in symptomatic patients, or for screening; 144 986 (21.2%) patients had only an NBCSP FOBT. A diagnosis of polyps, gastrointestinal inflammatory condition or haemorrhoids, or a referral to a gastroenterologist or general surgeon, was more commonly recorded in the 6 months after a GP-requested FOBT than after an NBCSP FOBT. Uptake of NBCSP FOBTs was lower among those with obesity, high alcohol consumption and current smokers, who are at higher risk of bowel cancer. Conclusions This study describes the patient characteristics, reasons and outcomes associated with GP-requested FOBTs, identifies under-screened population sub-groups, and suggests involvement of GPs to improve participation in the NBCSP.

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Castiglione, G., G. Grazzini, G. Miccinesi, T. Rubeca, C. Sani, P. Turco, and M. Zappa. "Basic variables at different positivity thresholds of a quantitative immunochemical test for faecal occult blood." Journal of Medical Screening 9, no. 3 (September 1, 2002): 99–103. http://dx.doi.org/10.1136/jms.9.3.99.

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OBJECTIVES: Screening by faecal occult blood testing (FOBT) is effective in decreasing mortality and incidence of colorectal cancer (CRC). Immunochemical tests have proved to be more cost effective than guaiac FOBTs. The latex agglutination test (LAT) has the advantage of being a fully automated, quantitative test. The aim of this study is to interpret the overall experience with LAT according to different positivity thresholds. SETTING: A population based screening programme is currently running involving subjects aged 50–70, invited every 2 years to have an FOBT. LAT is the standard screening test and has a positivity threshold for further diagnostic tests of 100 ng haemoglobin/ml of sample solution. METHODS: Positivity rates, detection rates for CRC high risk adenomas, and positive predictive values for CRC, high risk adenomas, and low risk adenomas were calculated for several positivity thresholds. RESULTS: 19 132 attendances at screening were recorded (11 774 at first screening, 7358 at subsequent screenings). Progressively increasing the positivity threshold from 100 to 200 ng/ml showed (a) a decrease in positivity rate; (b) a decrease in detection rates for CRC or high risk adenomas; (c) an increase in positive predictive values for cancer; (d) an increase in positive predictive value for high risk adenomas. CONCLUSIONS: Increasing the positivity threshold of the LAT reduces recall rate and improves positive predictive value for cancer or high risk adenomas but substantially decreases the detection rate of CRC and high risk adenomas. For this reason increasing the positivity cut off for LATs is not advisable. On the other hand decreasing the positivity threshold would increase recall rate and sensitivity of screening. Careful evaluation of sensitivity of the quantitative results of the LAT for interval cancers is needed to definitively assess the optimal positivity threshold for LATs in population based screening programmes.

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Grazzini, Grazia, Stefano Ciatto, Cesare Cislaghi, Guido Castiglione, Manuele Falcone, Paola Mantellini, and Marco Zappa. "Cost evaluation in a colorectal cancer screening programme by faecal occult blood test in the District of Florence." Journal of Medical Screening 15, no. 4 (December 2008): 175–81. http://dx.doi.org/10.1258/jms.2008.008032.

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Objectives To evaluate the direct costs of first and repeat colorectal cancer screening by immunochemical faecal occult blood testing (I-FOBT). Methods Florence district residents aged 50–70 were invited to undergo one-time I-FOBT every two years. Full colonoscopy was recommended for FOBT-positive subjects. Direct cost analysis was carried out separately for the first and repeat screening. All relevant resources consumed by the programme were calculated. Results Among 25,428 or 62,369 subjects invited to the first or repeat screening, respectively, the corresponding participation rate was 47.8% or 52.3%, and the positivity rate was 4.4% and 3.3%. Corresponding detection rates and positive predictive values for cancer and advanced adenoma were 11.3% or 8.9% and 32.4% or 32.8%, respectively. The assessment phase accounted for the major cost, as compared with recruitment and screening. All cost indicators were slightly higher in the first screening compared with repeat screening. Cost per cancer and advanced adenoma detected was similar in the first or repeat screening. A higher than observed participation rate would have substantially reduced screening cost. Conclusion Analysis of I-FOBT-organized population-based screening cost demonstrates lower cost at repeat compared with first screening and provides reference for decision-making in screening implementation.

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Brown, Louise F., and Callum G. Fraser. "Effect of delay in sampling on haemoglobin determined by faecal immunochemical tests." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 45, no. 6 (September 9, 2008): 604–5. http://dx.doi.org/10.1258/acb.2008.008024.

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Background Faeces must be sampled directly onto guaiac-based faecal occult blood test (FOBT) cards since analysis of specimens collected in traditional faeces containers is inappropriate because degradation of haemoglobin continues after faeces have been passed. Newer faecal immunochemical tests (FIT) are replacing FOBT, but it is likely that the practice of obtaining specimens in traditional faeces collection containers for later analysis will continue. The aim of this study was to assess the effect of delay in stool sampling on FIT. Methods Five specimens of faeces from healthy volunteers, all qualitatively FIT negative, were supplemented with whole blood haemolysate to three different FIT positive concentrations. Each sample was analysed daily after 1–14 days delay using a quantitative latex immunoturbidimetric-based FIT and also after five and ten days delay using a qualitative FIT. Results Haemoglobin concentrations fell each day, the rate being generally proportional to the original haemoglobin concentration. After eight days delay, no sample had a haemoglobin concentration >100 ng/mL and, after nine days, no sample had a haemoglobin concentration >50 ng/mL. After five days delay, five of the 15 supplemented faeces with initially positive qualitative FIT had negative FIT; after 10 days, none had positive FIT. Conclusion False-negative results will occur if sampling of fresh faeces into or onto FIT collection devices is delayed. Laboratories that undertake FIT analyses on faeces collected into traditional containers are likely to miss significant neoplasia. FIT collection devices must be used for sampling fresh faeces.

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Lecis, P., S. Mancuso, G. Bertiato, E. Galliani, F. Soppelsa, R. Mel, R. Schiavon, A. Quaranta, S. Di Camillo, and B. Germanà. "Colorectal cancer screening with immunochemical faecal occult blood test (FOBT): Intermediate results with high acceptance rate." Digestive and Liver Disease 38 (April 2006): S113. http://dx.doi.org/10.1016/s1590-8658(06)80302-6.

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Cole, S. R., G. Young, D. Byrne, J. Guy, and J. Morcom. "Participation in screening for colorectal cancer based on a faecal occult blood test is improved by endorsement by the primary care practitioner." Journal of Medical Screening 9, no. 4 (December 1, 2002): 147–52. http://dx.doi.org/10.1136/jms.9.4.147.

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OBJECTIVES: To investigate the influence of general practitioner (GP) endorsement on participation in screening for colorectal cancer based on a faecal occult blood test (FOBT). SETTING: South Australian residents (n=2400), in 1999, aged >50 years. METHODS: Random selection of three groups (GP1, GP2, GP3) from two general practices and of one group (ER) from the federal electoral roll; n=600 per group. Without previous communication or publicity, subjects were posted an offer of screening by immunochemical FOBT. The GP1 and ER groups were invited without indication that their GP was involved; GP2 received an invitation indicating support from the practice; and GP3 received an invitation on practice letterhead and signed by a practice partner. A reminder was posted at 6 weeks. Participation was defined as return of correctly completed FOBT sample cards within 12 weeks. RESULTS: Participation rates were: GP1 192/600 (32.0%), GP2 228/600 (38.0%), and GP3 244/600 (40.7%); &khgr;2=10.2, p=0.006. Both GP2 and GP3 differed significantly from GP1 (odds ratio (OR) 0.77, 95% confidence interval (95% CI) 0.60 to 0.98 and relative risk (RR)=0.69, 95% CI 0.54 to 0.87 respectively). ER (193/600 (32.2%)) and GP1 were not significantly different. Age but not sex was significantly associated with participation. Overall test positivity rate was 4.6%; five malignancies were found in the 918 who performed FOBT. CONCLUSIONS: Association of a GP of recent contact with a screening offer in the form of a personalised letter of invitation achieves better participation than does the same letter from a centralised screening unit that does not mention the GP. Thus, GP enhanced participation is achievable without their actual involvement. Additional strategies are needed to further improve participation.

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George, AT, S. Aggarwal, M. Dube, A. Menon, M. Vogler, R. Logan, and A. Field. "PWE-282 Implications of a ‘false negative’ faecal occult blood test (FOBT) – results from a multicentre study." Gut 64, Suppl 1 (June 2015): A335.3—A336. http://dx.doi.org/10.1136/gutjnl-2015-309861.728.

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Todorov, Kamelia, Carlene Wilson, Greg Sharplin, and Nadia Corsini. "Faecal occult blood testing (FOBT)-based colorectal cancer screening trends and predictors of non-use: findings from the South Australian setting and implications for increasing FOBT uptake." Australian Health Review 42, no. 1 (2018): 45. http://dx.doi.org/10.1071/ah16126.

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Objective The present study used data from three South Australian population health surveys to examine trends in knowledge, recent use and reasons for use or non-use of faecal occult blood testing (FOBT) for colorectal cancer (CRC) screening from 2011 to 2014. Screening awareness and demographic factors related to non-use were also examined. Methods FOBT trends were examined for respondents aged 50–75 years across survey years (n ~ 1000). Logistic regression analyses were undertaken to determine predictors of non-use and reasons for non-use of FOBT based on latest data. Results The proportion of respondents reporting recent FOBT use has trended up, whereas the proportion reporting non-use has trended down. Awareness of screening recommendations has increased. Respondents who were aware of screening recommendations and those aged 65–69 years were significantly less likely to report non-use. The most commonly reported reasons for FOBT use were as part the national screening program or routine examination, whereas reasons for non-use were not having symptoms and doctor not advising to have the test. Conclusions FOBT screening trends are indicative of the positive effect of the continued expansion of the national screening program. FOBT uptake may be increased by addressing salient barriers, as indicated by persisting reasons for non-use of FOBT. What is known about the topic? Australia has one of the highest age-standardised incidence rates of CRC (or bowel cancer) in the world. Population screening using non-invasive stool-based FOBT was implemented in Australia in 2006 with the introduction of the National Bowel Cancer Screening Program (NBCSP). To date, the NBCSP has been extended to only a small proportion of the target population and FOBT screening rates remain well below desired levels to effect changes in CRC outcomes at the population level. There is a recognised need for more robust data on CRC screening practices to inform interventions aimed at increasing FOBT uptake, beyond the scope of the NBCSP. What does this paper add? The study provides valuable insights into trends of FOBT screening indicators over time in the South Australia, drawing on data from population state health surveys undertaken from 2011 to 2014. A particular advantage of the dataset was that it included data on reasons for use and non-use of FOBT. These data are not routinely assessed in population-level studies of FOBT uptake, although such information would be beneficial for tracking implementation of the national program and identifying salient barriers to FOBT uptake in low-participation groups. Thus, the study also describes factors related to non-use and reasons for non-use of FOBT among the target population for CRC screening. What are the implications for practitioners? Results suggest that there have been considerable shifts in community knowledge and FOBT screening participation rates from 2011 to 2014, reflecting the positive effect of the NBCSP. Reliance on physician recommendation to screen, as well as knowledge deficits related to screening frequency and the perceived relevance of screening remain prominent barriers to FOBT uptake. Recommendations for increasing FOBT uptake are made in view of salient barriers and identified segments of the population less likely to report FOBT use.

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Itoh, Masato, Ken Takahashi, Hiroshi Nishida, Kiyonobu Sakagami, and Toshiteru Okubo. "Estimation of the Optimal Cut Off Point in a New Immunological Faecal Occult Blood Test in a Corporate Colorectal Cancer Screening Programme." Journal of Medical Screening 3, no. 2 (June 1996): 66–71. http://dx.doi.org/10.1177/096914139600300204.

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Objective –To estimate the optimal cut off point in a new immunological method (OC-Hemodia®) for faecal occult blood testing (FOBT). Setting –A corporate colorectal cancer screening programme in Japan. Method –The screening programme targeted colorectal cancer and adenomatous polyps ≥ 10 mm, and was conducted on 27 860 participants (age ⩾ 40) during 1991–92. The follow up consisted of diagnostic management by total colonoscopy on positive screened subjects exceeding the manufacturer recommended cut off level of 50 ng/ml faecal haemoglobin, and the identification of false negative cases by health insurance claims. The optimal cut off point was estimated by the positive predictive value, receiver operating characteristic (ROC) curve, and a cost effectiveness analysis. In this study evaluation was carried out only for cancer as the target disease. Results –At the current cut off level of 50 ng/ml the sensitivity and specificity were 86.5% and 94.9%. When the optimal cut off point was estimated the highest positive predictive value was obtained at 250–350 ng/ml. The ROC curve showed that the sum of sensitivity and specificity is maximised at 50 ng/ml, but evaluation of the ratio, change in sensitivity/change in false positive rate, pointed to higher optimal cut off points, showing marked changes occurring at about 200 ng/ml. The average cost per case was lowest at 250–300 ng/ml. Overall, the optimal cut off point was estimated to be about 200 ng/ml, at which the sensitivity and specificity of the test would be 77.5% and 98.9%, respectively. Conclusion –The optimal cut off point of the new immunological method of FOBT was estimated to be about 200 ng/ml, a value which, more than the current cut off value, favours specificity over sensitivity.

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Pisani, P., C. Herrmann, D. Sighoko, T. Lignini, S. Ducarroz, and L. von Karsa. "P1-290 Estimates of avoidable deaths by faecal occult blood test (FOBT) screening for colorectal cancer in the EU." Journal of Epidemiology & Community Health 65, Suppl 1 (August 1, 2011): A147. http://dx.doi.org/10.1136/jech.2011.142976e.82.

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Ore, L., L. Hagoel, I. Lavi, and G. Rennert. "Screening with faecal occult blood test (FOBT) for colorectal cancer: assessment of two methods that attempt to improve compliance." European Journal of Cancer Prevention 10, no. 3 (June 2001): 251–56. http://dx.doi.org/10.1097/00008469-200106000-00008.

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Chapple, Alison, Sue Ziebland, Paul Hewitson, and Ann McPherson. "What affects the uptake of screening for bowel cancer using a faecal occult blood test (FOBt): A qualitative study." Social Science & Medicine 66, no. 12 (June 2008): 2425–35. http://dx.doi.org/10.1016/j.socscimed.2008.02.009.

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Weiss, Gunter, and Thomas Rösch. "Potential of a New Blood Test for Colorectal Cancer Screening –The Septin 9 Gene Biomarker." European Oncology & Haematology 06, no. 01 (2010): 51. http://dx.doi.org/10.17925/eoh.2010.06.1.51.

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Despite clear evidence for a better prognosis when detected early, in most countries colorectal cancer (CRC) has a low compliance rate in terms of screening. There are several methods of CRC screening ranging from a variety of stool tests, e.g. faecal occult blood test (FOBT), to endoscopy (sigmoidoscopy, colonoscopy). A blood test for CRC detection is a new alternative, at least for patients not willing to accept screening colonoscopy or to undergo FOBT. The septin 9 biomarker is a potential candidate to fulfil this purpose. It has been validated in several case–control studies, showing a strong association of plasma-containing methylated DNA within the septin 9 gene (mSEPT9) with the presence of CRC. If sensitive methylated-DNA-detection technologies are used formSEPT9 detection in blood plasma samples, sensitivities of about 50% for stage I, 70–80% for stages II and III and 90–100% for stage IV at a specificity of ≥90% have been reported in these studies. Screening experts assume that such a blood-based test will increase compliance to CRC screening. Further studies are ongoing or have just been completed, including a large prospective screening trial involving 8,000 individuals in the US and Germany. The main objectives of this clinical investigation, called Prospective Evaluation of Septin 9 Performance for Colorectal Cancer Screening (PRESEPT), are to determine the performance of the septin 9 test for identification of CRC in a screening population and to demonstrate the health economic benefit of septin 9 in this setting. Results are expected in April 2010. This article presents an update on current analytical and clinical data onmSEPT9.

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Nouni-García, Rauf, Ángela Lara-López, Concepción Carratalá-Munuera, Vicente F. Gil-Guillén, Adriana López-Pineda, Domingo Orozco-Beltrán, and Jose A. Quesada. "Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey." International Journal of Environmental Research and Public Health 19, no. 9 (April 29, 2022): 5460. http://dx.doi.org/10.3390/ijerph19095460.

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This study aimed to determine the CRC screening coverage of people aged between 50 and 69 years who were living in Spain in 2017 and describe the factors associated with not having had a faecal occult blood test (FOBT). A cross-sectional study was performed using data from the Spanish National Health Survey 2017. We analysed 7568 individuals between the ages of 50 and 69 years. The proportion of respondents between 50 and 69 years old who had had an FOBT was 29.0% (n = 2191). The three autonomous communities with the lowest proportion of respondents who had had an FOBT were Extremadura (8.7%, n = 16), Ceuta–Melilla (10.4%, n = 3), and Andalucia (14.1%, n = 186). The variables associated with not having had an FOBT were being 50–54 years old (PR = 1.09; 95% CI 1.04–1.14), having been born outside of Spain (PR = 1.11; 95% CI 1.06–1.16), not having been vaccinated against the flu (PR = 1.09; 95% CI 1.04–1.15), never having had a colonoscopy (PR = 1.49; 95% CI 1.40–1.59), not having had an ultrasound scan in the last year (PR = 1.09; 95% CI1.04–1.14), and not having seen a primary care physician in the last month (PR = 1.08; 95% CI1.04–1.12). The factors associated with not getting an FOBT were young age, having been born outside of Spain, not having been vaccinated against the flu in the last campaign, and not making frequent use of healthcare services.

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Castiglione, G., M. Zappa, G. Grazzini, C. Sani, A. Mazzotta, P. Mantellini, and S. Ciatto. "Cost Analysis in a Population Based Screening Programme for Colorectal Cancer: Comparison of Immunochemical and Guaiac Faecal Occult Blood Testing." Journal of Medical Screening 4, no. 3 (September 1997): 142–46. http://dx.doi.org/10.1177/096914139700400306.

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Objective— To compare the costs of colorectal cancer (CRC) screening by two faecal occult blood tests (FOBT)—namely, Hemoccult (guaiac based) and reversed passive haemagglutination (RPHA) tests. RPHA was interpreted according to two positivity thresholds (+ or +/-). Methods— Attenders performed both tests. Subjects with a positive FOBT test were invited to have a complete exploration of the colon. The total costs for every 10 000 screened subjects and costs for each unit of result (screened subject, or patient with adenoma/s or cancer detected) were calculated for both tests. Results— 8353 subjects were enrolled. A total of 2109 repeated screening after two years. RPHA(+ and +/-) showed the highest and RPHA(+) the lowest positivity rate at first screening. The Hemoccult positivity rate was highest at repeat screening. Total costs of screening by RPHA(+ and +/-) were highest as this method had the highest recall rate. Screening by RPHA(+) was the least costly. Costs for each screened subject were highest for RPHA(+ and +/-) and lowest for RPHA(+). Costs for each cancer detected were lowest for RPHA(+) and highest for Hemoccult or RPHA(+ and +/-) in subjects aged > 49 or < 50, respectively. Costs for subjects with detected adenoma/s of > 9 mm were lowest for RPHA(+ and +/-) and highest for Hemoccult. At repeat screening total costs of RPHA(+ and +/-) were lower than at first screening, whereas for each subject with cancer or adenoma/s costs were increased. Conclusions— Our data confirm that screening by RPHA is more cost effective than by Hemoccult.

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Purnomo, Hery Djagat, Cecilia Oktaria Permatadewi, Agung Prasetyo, Didik Indiarso, Hesti Triwahyu Hutami, Dik Puspasari, Devia Eka Listiana, et al. "Colorectal cancer screening in Semarang, Indonesia: A multicenter primary health care based study." PLOS ONE 18, no. 1 (January 3, 2023): e0279570. http://dx.doi.org/10.1371/journal.pone.0279570.

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Colorectal cancer (CRC) is a major public health problem in Indonesia. It ranks among the top four cancers with high mortality rates. CRC screening is expected to improve early diagnosis that can reduce mortality and morbidity rate. Primary health care-based CRC screening in Indonesia has not yet been performed. This study was conducted to obtain information about prevalence, adenoma detection rate and public compliance for CRC screening in Semarang, Indonesia. This cross-sectional study was done across 10 primary health care centers in Semarang during April—October 2021. The screening method used Immunochromatography Faecal Occult Blood Tests (I-FOBT) as the primary test. Patients with positive I-FOBT result would be referred to Kariadi hospital for colonoscopy and histology examination. A total of 221 patients were included, 66.1% were female, mean age was 59.38 ± 7.48 years. Participation rate was 63%, 37 patients (16.7%) were I-FOBT positive, 26 patients (70.27%) underwent colonoscopy. Colonoscopy compliance rate was 70.27%. The colonoscopy results were haemorrhoid (30.8%), polyps (30.8%), malignancy (19.2%), colitis (7.7%), diverticulosis (7.7%), and normal (3.8%). The adenoma detection rate was 26.9%. BMI abnormality (overweight and obese) (OR 10.968; 95% CI 2.33–51.55) and family history of malignancy (OR 18.800; 95% CI 5.13–68.85) increased the risk of colorectal cancer and adenoma and respectively. The prevalence of I-FOBT positive in primary health care centers is high. The CRC screening program based on primary care should be considered. Public awareness education should be considered to increase colonoscopy compliance.

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Clifford, G. M., J. Shenfine, H. Jaretzke, and C. J. Rees. "PTH-141 Could upper GI Cancer Explain False Positive Faecal Occult Blood Test (FOBT) Results in the Bowel Cancer Screening Programme?" Gut 62, Suppl 1 (June 2013): A268.2—A269. http://dx.doi.org/10.1136/gutjnl-2013-304907.628.

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Kaushal, Aradhna, Sandro Tiziano Stoffel, Robert Kerrison, and Christian von Wagner. "Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study." BMJ Open 10, no. 7 (July 2020): e035264. http://dx.doi.org/10.1136/bmjopen-2019-035264.

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ObjectivesIn England, a significant proportion of people who take part in the national bowel cancer screening programme (BCSP) and have a positive faecal occult blood test (FOBt) result, do not attend follow-up colonoscopy (CC). The aim of this study was to investigate differences in intended participation in a follow-up investigation by diagnostic modality offered including CC, CT colonography (CTC) or capsule endoscopy (CE).SettingWe performed a randomised online experiment with individuals who had previously completed an FOBt as part of the English BCSP.MethodsParticipants (n=953) were randomly allocated to receive one of three online vignettes asking participants to imagine they had received an abnormal FOBt result, and that they had been invited for a follow-up test. The follow-up test offered was either: CC (n=346), CTC (n=302) or CE (n=305). Participants were then asked how likely they were to have their allocated test or if they refused, either of the other tests. Respondents were also asked to cite possible emotional and practical barriers to follow up testing. Multivariable logistic regression models were used to investigate intentions.ResultsIntention to have the test was higher in the CTC group (96.7%) compared with the CC group (91.8%; OR 2.64; 95% CI 1.22 to 5.73). CTC was considered less ‘off-putting’ (OR 0.66, 95% CI 0.47 to 0.94) and less uncomfortable compared with CC (OR 0.51, 95% CI 0.34 to 0.77). For those who did not intend to have the test they were offered, CE (39.7%) or no investigation (34.5%) was preferable to CC (8.6%) or CTC (17.2%).ConclusionsAlternative tests have the potential to increase attendance at diagnostic follow-up appointments.

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Zullo, Angelo, Vincenzo De Francesco, Raffaele Manta, Lorenzo Ridola, and Roberto Lorenzetti. "A Challenging Diagnosis of Jejunal Adenocarcinoma in a Celiac Patient: Case Report and Systematic Review of the Literature." Journal of Gastrointestinal and Liver Diseases 26, no. 4 (December 1, 2017): 411–15. http://dx.doi.org/10.15403/jgld.2014.1121.264.zet.

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Celiac disease (CD) is a common and chronic disorder requiring a long-life gluten-free diet. There is evidence that asymptomatic or subclinical presentation of CD has increased in the last decades, so that several cases are diagnosed during adulthood or even in the elderly. Celiac disease patients are at an increased risk of developing malignancies, particularly when the disease is diagnosed in the elderly. We describe a case of a challenging diagnosis of small bowel adenocarcinoma which developed in a patient with CD discovered only in the elderly. We also performed a systematic review of the literature. A tailored follow-up in a sub-group of CD patients at an increased risk of developing intestinal adenocarcinoma could be implemented.Abbreviations: CD: Celiac disease; GP: General Practitioner; FOBT: faecal occult blood test; EMA: anti-endomysial antibodies; tTG: anti-tissue transglutaminase antibodies; Hgb: hemoglobin; VCE: videocapsule endoscopy.

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Westwood, Marie, Isaac Corro Ramos, Shona Lang, Marianne Luyendijk, Remziye Zaim, Lisa Stirk, Maiwenn Al, Nigel Armstrong, and Jos Kleijnen. "Faecal immunochemical tests to triage patients with lower abdominal symptoms for suspected colorectal cancer referrals in primary care: a systematic review and cost-effectiveness analysis." Health Technology Assessment 21, no. 33 (May 2017): 1–234. http://dx.doi.org/10.3310/hta21330.

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BackgroundColorectal cancer (CRC) is the third most common cancer in the UK. Presenting symptoms that can be associated with CRC usually have another explanation. Faecal immunochemical tests (FITs) detect blood that is not visible to the naked eye and may help to select patients who are likely to benefit from further investigation.ObjectivesTo assess the effectiveness of FITs [OC-Sensor (Eiken Chemical Co./MAST Diagnostics, Tokyo, Japan), HM-JACKarc (Kyowa Medex/Alpha Laboratories Ltd, Tokyo, Japan), FOB Gold (Sentinel/Sysmex, Sentinel Diagnostics, Milan, Italy), RIDASCREEN Hb or RIDASCREEN Hb/Hp complex (R-Biopharm, Darmstadt, Germany)] for primary care triage of people with low-risk symptoms.MethodsTwenty-four resources were searched to March 2016. Review methods followed published guidelines. Summary estimates were calculated using a bivariate model or a random-effects logistic regression model. The cost-effectiveness analysis considered long-term costs and quality-adjusted life-years (QALYs) that were associated with different faecal occult blood tests and direct colonoscopy referral. Modelling comprised a diagnostic decision model, a Markov model for long-term costs and QALYs that were associated with CRC treatment and progression, and a Markov model for QALYs that were associated with no CRC.ResultsWe included 10 studies. Using a single sample and 10 µg Hb/g faeces threshold, sensitivity estimates for OC-Sensor [92.1%, 95% confidence interval (CI) 86.9% to 95.3%] and HM-JACKarc (100%, 95% CI 71.5% to 100%) indicated that both may be useful to rule out CRC. Specificity estimates were 85.8% (95% CI 78.3% to 91.0%) and 76.6% (95% CI 72.6% to 80.3%). Triage using FITs could rule out CRC and avoid colonoscopy in approximately 75% of symptomatic patients. Data from our systematic review suggest that 22.5–93% of patients with a positive FIT and no CRC have other significant bowel pathologies. The results of the base-case analysis suggested minimal difference in QALYs between all of the strategies; no triage (referral straight to colonoscopy) is the most expensive. Faecal immunochemical testing was cost-effective (cheaper and more, or only slightly less, effective) compared with no triage. Faecal immunochemical testing was more effective and costly than guaiac faecal occult blood testing, but remained cost-effective at a threshold incremental cost-effectiveness ratio of £30,000. The results of scenario analyses did not differ substantively from the base-case. Results were better for faecal immunochemical testing when accuracy of the guaiac faecal occult blood test (gFOBT) was based on studies that were more representative of the correct population.LimitationsOnly one included study evaluated faecal immunochemical testing in primary care; however, all of the other studies evaluated faecal immunochemical testing at the point of referral. Further, validation data for the Faecal haemoglobin, Age and Sex Test (FAST) score, which includes faecal immunochemical testing, showed no significant difference in performance between primary and secondary care. There were insufficient data to adequately assess FOB Gold, RIDASCREEN Hb or RIDASCREEN Hb/Hp complex. No study compared FIT assays, or FIT assays versus gFOBT; all of the data included in this assessment refer to the clinical effectiveness of individual FIT methods andnottheir comparative effectiveness.ConclusionsFaecal immunochemical testing is likely to be a clinically effective and cost-effective strategy for triaging people who are presenting, in primary care settings, with lower abdominal symptoms and who are at low risk for CRC. Further research is required to confirm the effectiveness of faecal immunochemical testing in primary care practice and to compare the performance of different FIT assays.Study registrationThis study is registered as PROSPERO CRD42016037723.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Mansouri, David, Donald McMillan, Emilia M. Crighton, and Paul G. Horgan. "Determinants of anemia in screen-detected colorectal cancer." Journal of Clinical Oncology 32, no. 3_suppl (January 20, 2014): 430. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.430.

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430 Background: Anaemia is an important clinical feature in colorectal cancer, since it may result in blood transfusion that may in turn compromise long term survival. The aim of the present study was to examine the relationship between tumour and host features, and anaemia in patients undergoing surgery for screen detected colorectal cancer. Methods: A prospectively maintained database of patients with cancer detected through a population based faecal occult blood test (FOBt) screening programme was analysed. Preoperative anaemia was defined as Hb<115 g/l in females and Hb<130 g/l in males. The amount of blood in the stool was classified on the degree of positivity of the FOBt (strong/weak) and the SIR was measured by the preoperative neutrophil to lymphocyte ratio (NLR>5/NLR<5). Results: A total of 263 patients were included: 174 (66%) males, 49 (19%) rectal, 177 (67%) node negative. Preoperative anaemia was present in 61 (23%) patients. The presence of anaemia was associated with more advanced T-stage (5% T1 vs. 42% T4, p<0.001), advanced N-stage (18% N0 vs. 45% N2, p=0.001), and the presence of a right-sided tumour (44% vs. 14%, p<0.001). In addition, anaemia was more likely to be present in patients with a strongly positive FOBt (30% strong vs. 19% weak, p=0.034), and in patients with an elevated SIR (44% vs 22%, p=0.045). Right-sided tumours were more likely to be strongly positive on FOBt compared to left-sided tumours (43% vs. 34%, p=0.053). Furthermore, strong FOBt positivity was associated with advanced T-stage (p=0.015), however was not associated with the presence of an elevated SIR (p=0.604). When T-stage, FOBt positivity and the SIR were examined in binary logistic regression analysis, only advanced T-stage (O.R. 2.82, 95% C.I. 1.32 – 6.02, p=0.008) remained significant in predicting those more likely to be anaemic. Conclusions: In this predominantly early stage cohort of screen-detected colorectal cancer, anaemia was uncommon. Its presence was related to both a greater amount of enteric blood loss and an elevated SIR, however these appear to be driven by the stage of the tumour itself. Further work, exploring in more detail the mechanism by which anaemia develops in early stage colorectal cancer is required.

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Waldmann, Elisabeth, Jaroslaw Regula, and Monika Ferlitsch. "How Can Screening Colonoscopy Be Optimized?" Digestive Diseases 33, no. 1 (December 17, 2014): 19–27. http://dx.doi.org/10.1159/000366033.

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Since the implementation of screening programmes, both the incidence and mortality of colorectal cancer have been decreasing. The choice of the preferred screening tool, however, is divergent and the adherence to screening programmes in most countries is still low. Cancer detection tests such as the guaiac faecal occult blood test (gFOBT) and the immunohistochemical FOBT (iFOBT) achieve higher acceptance than endoscopy. The sensitivity and specificity of iFOBT are higher than those of gFOBT, but gFOBT is cheaper and easier to perform. Endoscopic screening, which represents cancer prevention tests, has higher sensitivity for premalignant lesions than gFOBT and iFOBT and enables diagnosis and therapy in one single procedure. Since screening colonoscopy and sigmoidoscopy are invasive procedures with potentially severe adverse events, the highest possible quality must be provided. High-tech equipment, experience, training, quality control programmes, excellent bowel preparation and low adverse event rates are pivotal. Alternative screening tools such as CT colonography, barium enema CT and multitarget stool DNA tests have not been established as routine screening tools to date.

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O'Sullivan, I., and S. Orbell. "Self-Sampling in Screening to Reduce Mortality from Colorectal Cancer: A Qualitative Exploration of the Decision to Complete a Faecal Occult Blood Test (FOBT)." Journal of Medical Screening 11, no. 1 (March 2004): 16–22. http://dx.doi.org/10.1177/096914130301100105.

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O'Sullivan, I., and S. Orbell. "Self-sampling in screening to reduce mortality from colorectal cancer: a qualitative exploration of the decision to complete a faecal occult blood test (FOBT)." Journal of Medical Screening 11, no. 1 (March 1, 2004): 16–22. http://dx.doi.org/10.1258/096914104772950709.

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Howarth, Georgina F., Michael H. Robinson, Jack D. Hardcastle, and Richard F. Logan. "How often is a positive faecal occult blood (FOB) test the result of coeliac disease (CD)?" Gastroenterology 118, no. 4 (April 2000): A696. http://dx.doi.org/10.1016/s0016-5085(00)84917-3.

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Yusoff, Masliza, Faridah Mohd Zin, Norwati Daud, Harmy Mohamed Yusoff, and Nani Draman. "Colorectal Cancer Screening: Knowledge and Practice among Private General Practitioners in Northeast Peninsular Malaysia." Education in Medicine Journal 13, no. 1 (March 31, 2021): 43–55. http://dx.doi.org/10.21315/eimj2021.13.1.5.

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Colorectal cancer screening is an important screening to detect colorectal cancer. Thus, the aim of this study is to determine the knowledge, practice and its associated factors of colorectal cancer screening among private general practitioners (PGPs) in Northeast Peninsular Malaysia. Crosssectional study was conducted involving 127 PGPs in Kelantan. The study used a validated selfadministrated questionnaire that contained three domains. The domains were sociodemographic, knowledge and practice of colorectal cancer screening. The inclusion criterion was doctors working in a private clinic for more than six months, while the exclusion criteria were non-residential doctors and doctors practicing in private specialised clinics. Only 21.3% of PGPs had good knowledge and 3.9% had good practice on colorectal cancer screening. The duration of practice as a PGP was significantly associated with good practice for colorectal cancer screening. Only 58.3% were aware of the current recommendation on colorectal cancer screening. Most PGPs would refer patients for a colonoscopy, but screening with faecal occult blood test (FOBT) in average-risk patients was low. Only 4% of PGPs followed the recommended guidelines for colorectal cancer screening. The main reasons for not offering FOBT screening were patients’ refusal, patients were not regular patients of the doctor and the referral system for colonoscopy was found to be difficult. This study noted that knowledge and practice of colorectal cancer screening among PGPs were inadequate. Overcoming barriers for screening is important to promote colorectal cancer screening.

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Mansouri, David, Donald C. Mcmillan, David S. Morrison, Emilia M. Crighton, and Paul G. Horgan. "Efficacy of a population-based colorectal cancer screening program and analysis of outcomes in screen-detected and non-screen-detected tumors." Journal of Clinical Oncology 32, no. 3_suppl (January 20, 2014): 394. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.394.

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394 Background: Population based faecal occult blood test (FOBt) screening for colorectal cancer reduces cancer specific mortality through the detection of early stage disease. However, programmes are limited by uptake and the characteristics of the test itself. The aim of the present study was to compare features of screen detected (SD) and non-screen detected tumours (NSD) and assess the effect on cancer specific mortality. Methods: Prospectively maintained databases of both the prevalence round of a biennial population based FOBt screening programme and a regional cancer audit database were analysed. Mortality data was obtained from the national registry. Results: Of the 395,097 males and females aged 50 to 74yrs invited to screening, 203,886 (52%) responded, 6,085 (3%) tested positive and 4,632 (76%) attended for colonoscopy. A total of 951 patients were diagnosed with cancer within two years of screening invite: 378 (40%) SD and 573 (60%) NSD. Of the NSD patients, 376 (66%) were non-responders, 134 (23%) were FOBt negative and 63 (11%) did not attend or did not have cancer diagnosed at colonoscopy. Therefore, estimated FOBt sensitivity was 77%, and specificity was 99%. Comparing SD and NSD patients, SD patients were more likely to be male, less socioeconomically deprived, have a tumour with a lower Dukes stage, and more likely to have a left-sided tumour (all p<0.05). In addition, SD patients were more likely to undergo an operation with a curative intent, less likely to undergo an emergency procedure, and less likely to die within 30 days of their procedure (all p<0.001). With a median follow-up of 2 years, SD patients had improved cancer specific survival versus NSD patients (p<0.001). This remained significant on multivariate survival analysis (Cox proportional hazards) including age, sex, deprivation, emergency presentation, tumour site and stage, and curative surgery (p<0.001). Conclusions: Independent of established prognostic factors, SD patients have more favourable outcomes than those with NSD tumours. Therefore, further studies to improve the response rate to a screening invitation and the sensitivity of the current screening test are warranted.

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Saratzis, A., J. Winter-Beatty, C. El-Sayed, R. Pande, and C. Harmston. "Colorectal cancer screening characteristics of patients presenting with symptoms of colorectal cancer and effect on clinical outcomes." Annals of The Royal College of Surgeons of England 97, no. 5 (July 2015): 369–74. http://dx.doi.org/10.1308/003588415x14181254789565.

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Introduction National colorectal cancer screening, utilising a faecal occult blood test (FOBT), is now well established in the UK. The aim of this study was to define the screening characteristics of patients presenting to secondary care with symptoms of colorectal cancer and to assess the effect of screening outcome on subsequent symptomatic presentation. Methods This was a retrospective analysis of all patients of screening age presenting within one calendar year in a tertiary trust via a two-week wait (2WW) pathway owing to suspicion of colorectal cancer. Colorectal cancer related outcomes were compared between patients in the cohort who had previously accepted bowel cancer screening and patients who had previously declined bowel cancer screening. The primary endpoint was overall incidence of colorectal neoplasia. Secondary endpoints included incidence of colorectal malignancy, cancer related mortality, cancer related outcomes and polyp related outcomes. Results Overall, 2,227 patients presented via the 2WW pathway; 955 were aged 60–75 years. Among the latter, 411 (43%) had been screened previously and had a negative FOBT, and 544 (57%) had declined screening. Incidence of colorectal neoplasia did not differ between the two groups (113 [27%] vs 143 [26%], p=0.7). Of those with a negative FOBT and subsequent symptomatic presentation, 16 (3.9%) were diagnosed with a colorectal malignancy compared with 36 (6.6%) of those who declined screening and had subsequent symptomatic presentation (relative risk: 1.7, 95% confidence interval: 0.96–3.02, p=0.08). There were no differences between the two groups with regard to TNM (tumour, lymph nodes, metastasis) stage, Dukes’ stage, metastases, number of polyps or cancer related mortality (median follow-up duration: 20 months). Conclusions The incidence of colorectal neoplasia was similar among patients who previously had a negative FOBT and those who declined screening. There was a higher incidence of colorectal cancer detected among those who declined screening but it did not reach statistical significance. All other cancer and polyp outcomes were similar between the groups.

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guez, A., V. Goldberg, H. Viotti, and G. Ciappesoni. "Early detection of Haemonchus contortus infection in sheep using three different faecal occult blood tests." Open Veterinary Journal 5, no. 2 (2015): 90. http://dx.doi.org/10.5455/ovj.2015.v5.i2.p90.

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Haemonchus contortus is a blood-sucking parasite causing the presence of faecal occult blood (FOB). The objective was to study three different FOB tests in order to have a new indicator of H. contortus infection in sheep that could be included in the genetic evaluation system as an alternative selection criterion to faecal worm egg count (FEC). A total of 29 Corriedale lambs were experimentally infected with 10.000 larvae of H. contortus. Stool samples were recorded for FEC and FOB tests (Hexagon, Hematest® and Multistix®), blood for packed cell volume (PCV), haemoglobin, white and red blood cell count (RBC), and FAMACHA© for scoring anaemia. At the end of the experiment lambs were slaughtered to worm burden count. Field infection was achieved in 309 Merino lambs under natural parasite challenge. FEC data were normalized through logarithmic transformation (LnFEC). Pearson correlation was estimated to examine the relationship between all traits. The three tests were able to detect the presence of FOB at day 11. FEC, PCV and RBC decreased to sub-normal values from day 18. FAMACHA© score 3 was considered to be indicative of anaemia. Most of the correlations were of high magnitude, with the exception of Multistix® test that was moderately correlated with haematological parameters, LnFEC and FEC. In field infection, most samples were negative to FOB tests and the correlations were lower than those calculated under experimental infection. In conclusion, FOB tests were able to detect haemonchosis earlier than FEC under high experimental parasite challenge. However, they were not able to detect FOB under natural mixed parasite challenge. FAMACHA© and PCV demonstrated to be good indicators of Haemonchosis, having moderate to high correlations with FEC.

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Ngu, Wee Sing, Roisin Bevan, Zacharias P. Tsiamoulos, Paul Bassett, Zoë Hoare, Matthew D. Rutter, Gayle Clifford, et al. "Improved adenoma detection with Endocuff Vision: the ADENOMA randomised controlled trial." Gut 68, no. 2 (January 23, 2018): 280–88. http://dx.doi.org/10.1136/gutjnl-2017-314889.

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ObjectiveLow adenoma detection rates (ADR) are linked to increased postcolonoscopy colorectal cancer rates and reduced cancer survival. Devices to enhance mucosal visualisation such as Endocuff Vision (EV) may improve ADR. This multicentre randomised controlled trial compared ADR between EV-assisted colonoscopy (EAC) and standard colonoscopy (SC).DesignPatients referred because of symptoms, surveillance or following a positive faecal occult blood test (FOBt) as part of the Bowel Cancer Screening Programme were recruited from seven hospitals. ADR, mean adenomas per procedure, size and location of adenomas, sessile serrated polyps, EV removal rate, caecal intubation rate, procedural time, patient experience, effect of EV on workload and adverse events were measured.Results1772 patients (57% male, mean age 62 years) were recruited over 16 months with 45% recruited through screening. EAC increased ADR globally from 36.2% to 40.9% (P=0.02). The increase was driven by a 10.8% increase in FOBt-positive screening patients (50.9% SC vs 61.7% EAC, P<0.001). EV patients had higher detection of mean adenomas per procedure, sessile serrated polyps, left-sided, diminutive, small adenomas and cancers (cancer 4.1% vs 2.3%, P=0.02). EV removal rate was 4.1%. Median intubation was a minute quicker with EAC (P=0.001), with no difference in caecal intubation rate or withdrawal time. EAC was well tolerated but caused a minor increase in discomfort on anal intubation in patients undergoing colonoscopy with no or minimal sedation. There were no significant EV adverse events.ConclusionEV significantly improved ADR in bowel cancer screening patients and should be used to improve colonoscopic detection.Trial registration numberNCT02552017, Results; ISRCTN11821044, Results.

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Dogaroiu, C., I. Diac, A. Petca, M. Gaiculescu, C. Trandafir, L. Matei, and RC Petca. "A comparison between rapid stain identification-blood (RSID-blood) and faecal occult blood test (FOB)to identify human blood on various suspicious stains." Romanian Journal of Legal Medicine 27, no. 4 (December 5, 2019): 373–78. http://dx.doi.org/10.4323/rjlm.2019.373.

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Von Wagner, Christian, Sandro Tiziano Stoffel, Madeline Freeman, Helga E. Laszlo, Brian D. Nicholson, Jessica Sheringham, Dorothy Szinay, and Yasemin Hirst. "General practitioners’ awareness of the recommendations for faecal immunochemical tests (FITs) for suspected lower gastrointestinal cancers: a national survey." BMJ Open 9, no. 4 (April 2019): e025737. http://dx.doi.org/10.1136/bmjopen-2018-025737.

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ObjectivesIn July 2017, UK National Institute for Health and Care Excellence (NICE) published a diagnostic guidance (DG30) recommending the use of faecal immunochemical tests (FITs) for symptomatic patients who do not meet the urgent referral pathway for suspected colorectal cancer (CRC). We assessed general practitioners’ (GP) awareness of DG30 in primary care 6 months after its publication.Design and settingCross-sectional online survey of GPs hosted by an English panel of Primary health care professionals.ParticipantsIn December 2017, 1024 GPs registered on an online panel (M3) based in England took part in an online survey.Outcomes and variablesWe investigated a number of factors including previous experience of using FIT and guaiac faecal occult blood tests (FOBTs), the number of urgent referrals for CRC that GPs have made in the last year and their sociodemographic and professional characteristics that could be associated with their self-reported awareness of the FIT diagnostic guidance.ResultsOf the 1024 GPs who completed the survey, 432 (42.2%) were aware of the current recommendation but only 102 (10%) had used it to guide their referrals. Awareness was lowest in North West England compared with London (30.5% vs 44.9%; adjusted OR: 0.55, 95% CI 0.33 to 0.92). Awareness of the FIT guidance was positively associated with test usage after the NICE update (adjusted OR: 13.00, 95% CI 6.87 to 24.61) and having specialist training (adjusted OR: 1.48, 95% CI 1.05 to 2.08). The number of urgent referrals, the previous use of FOBt, GPs’ age and gender, work experience and practice size (both in terms of the number of GPs or patients at the practice) were not associated with awareness.ConclusionsLess than half of GPs in this survey recognised the current guidance on the use of FIT. Self-reported awareness was not systematically related to demographic of professional characteristics.

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Bretagne, Jean-François, Christine Piette, Sylvain Manfredi, Gaud Mallard, and Gérard Durand. "S1122 Screening for Colorectal Cancer with Faecal Occult Blood Test (FOBT): Findings of the Second Round Compared with Those of the First Round in One French District." Gastroenterology 134, no. 4 (April 2008): A—182. http://dx.doi.org/10.1016/s0016-5085(08)60844-6.

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Pengpid, Supa, Chao Zhang, and Karl Peltzer. "The Prevalence and Associated Factors of Cancer Screening Uptake Among a National Population-Based Sample of Adults in Marshall Islands." Cancer Control 28 (January 1, 2021): 107327482199749. http://dx.doi.org/10.1177/1073274821997497.

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Background: The study aimed to estimate the prevalence and associated factors of cancer screening among men and women in the general population in Marshall Islands. Methods: The national cross-sectional sub-study population consisted of 2,813 persons aged 21-75 years (Median = 37.4 years) from the “2017/2018 Marshall Islands STEPS survey”. Information about cancer screening uptake included Pap smear or Vaginal Inspection with Acetic Acid (=VIA), clinical breast examination, mammography, faecal occult blood test (FOBT), and colonoscopy. Results: The prevalence of past 2 years mammography screening was 21.7% among women aged 50-74 years, past year CBE 15.9% among women aged 40 years and older, past 3 years Pap smear or VIA 32.6% among women 21-65 years, past year FOBT 21.8% among women and 22.3% among men aged 50-75 years, and past 10 years colonoscopy 9.1% among women and 7.3% among men aged 50-75 years. In adjusted logistic regression, cholesterol screening (AOR: 1.91, 95% CI: 1.07-3.41) was associated with past 2 years mammography screening among women aged 50-74 years. Blood pressure screening (AOR: 2.39, 95% CI: 1.71-3.35), glucose screening (AOR: 1.59, 95% CI: 1.13-2.23), dental visit in the past year (AOR: 1.51, 95% CI: 1.17, 1.96), binge drinking (AOR: 1.88, 95% CI: 1.07-3.30), and 2-3 servings of fruit and vegetable consumption a day (AOR: 1.42, 95% CI: 1.03-1.95) were positively and high physical activity (30 days a month) (AOR: 0.56, 95% CI: 0.41-0.76) was negatively associated with Pap smear or VIA screening among women aged 21-65 years. Higher education (AOR: 2.58, 95% CI: 1.02-6.58), and cholesterol screening (AOR: 2.87, 95% CI: 1.48-5.59), were positively and current smoking (AOR: 0.09, 95% CI: 0.01-0.65) was negatively associated with past 10 years colonoscopy uptake among 50-75 year-olds. Conclusion: The study showed a low cancer screening uptake, and several factors were identified that can assist in promoting cancer screening in Marshall Islands.

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Howard, Kirsten, Glenn Salkeld, Les Irwig, and Barbara-Ann Adelstein. "High participation rates are not necessary for cost-effective colorectal cancer screening." Journal of Medical Screening 12, no. 2 (June 1, 2005): 96–102. http://dx.doi.org/10.1258/0969141053908276.

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Background: In many countries high participation is an explicit target in screening programmes. The desire for high participation often appears to drive screening policy, although it is increasingly recognized that encouraging high participation may impinge upon the rights of an individual to make an informed choice. One argument offered in support of high participation is that it improves the cost-effectiveness of screening. This is questionable on theoretical grounds, and empirically there are conflicting results. Two recent cost-effectiveness models of faecal occult blood test (FOBT) screening for colorectal cancer (CRC) showed that cost-effectiveness was improved, another showed that cost-effectiveness was worsened and a fourth indicated that cost-effectiveness was unaffected by increasing the participation rate. Methods: We assessed the extent to which different levels and patterns of participation affect cost-effectiveness, using decision modelling of three CRC screening with FOBT scenarios. We estimate the incremental cost-effectiveness (value for money) ratios for each scenario. Results: The way in which participation is modelled, particularly assumptions made about the subsequent screening behaviour of non-participants ('if' and 'when' a non-participant attends for subsequent screening), affects the cost-effectiveness estimates for FOBT screening programmes. 100% participation in all screening rounds gives a cost per life year saved (LYS) of US&dollar;9705. Cost-effectiveness is worst when people who do not take part in one screening round (initial or subsequent) never take part in any future rounds of screening. Under this scenario, a participation rate of 20% in second and subsequent rounds gives a cost per LYS of US&dollar;29,500. Under more realistic assumptions, for example the attendance of even a small proportion of non-participants in subsequent rounds, cost-effectiveness is more favourable and similar to that achieved for full participation: the scenario with a random participation rate of 20% in second and subsequent rounds for both participants and non-participants has a cost per LYS of US&dollar;11,270. Conclusions: Contrary to a commonly held view, high participation in screening programmes is not necessary to achieve cost-effectiveness. Setting high target participation rates in screening programmes does not guarantee cost-effectiveness and may in certain circumstances reduce the cost-effectiveness.

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Jézéquel, Caroline, Sylvain Manfredi, Gaud Mallard, Christine Piette, Gérard Durand, and Jean-François Bretagne. "T1103 What Is the Proportion of Screened and Interval Cancers Among Overall Colorectal Cancers Diagnosed in a French District Implying a Mass Screening Programme with Faecal Occult Blood Test (FOBT)?" Gastroenterology 134, no. 4 (April 2008): A—484. http://dx.doi.org/10.1016/s0016-5085(08)62264-7.

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Nylander, D., and M. Ritchie. "PMO-212 Patients with positive faecal occult blood test (FOBt) following previous low risk colonoscopy in the bowel cancer screening programme: should current approach be changed?: Abstract PMO-212 Table 1." Gut 61, Suppl 2 (May 28, 2012): A160.2—A160. http://dx.doi.org/10.1136/gutjnl-2012-302514b.212.

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Majumdar, D., J. Patnick, C. Nickerson, and M. D. Rutter. "PWE-076 Continued biennial screening of faecal occult blood test (FOBT) positive and screening colonoscopy negative cohort in English bowel cancer screening programme—is it necessary?: Abstract PWE-076 Table 1." Gut 61, Suppl 2 (May 28, 2012): A328.1—A328. http://dx.doi.org/10.1136/gutjnl-2012-302514d.76.

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Bretagne, Jean-François, Françoise Riou, Christine Piette, Emmanuelle Leray, Dorina Bratu, Sylvain Manfredi, and Gérard Durand. "T1097 The Adenoma and Cancer Detection Rate: Do Inter-Endoscopists' Variations Happen in the Field of a Mass Screening Programme Based On Colonoscopy Following a Positive Faecal Occult Blood Test (FOBT) Result?" Gastroenterology 134, no. 4 (April 2008): A—482—A—483. http://dx.doi.org/10.1016/s0016-5085(08)62258-1.

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Bretagne, Jean-François, Christine Piette, Gaud Mallard, Sylvain Manfredi, and Gérard Durand. "S1123 Yield of High-Grade Dysplasia and Intra-Mucosal Carcinoma (Tis) Based On Adenomas Size. Results of a Prospective Population-Based Series of Colonoscopies Following a Positive Faecal Occult Blood Test (FOBT) Result." Gastroenterology 134, no. 4 (April 2008): A—182—A—183. http://dx.doi.org/10.1016/s0016-5085(08)60845-8.

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Malila, Nea, Ahti Anttila, and Matti Hakama. "Colorectal cancer screening in Finland: details of the national screening programme implemented in Autumn 2004." Journal of Medical Screening 12, no. 1 (March 1, 2005): 28–32. http://dx.doi.org/10.1258/0969141053279095.

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Colorectal cancer mortality can be reduced by repeated faecal occult blood (FOB) testing followed by colonoscopy for test positives. The object of this report is to describe how to launch a new screening programme in such a way that its effectiveness can be reliably evaluated. The programmeis based on gradual expansion over time with individual-level randomization into screening or control arms among a target population aged 60–69 years in Finland. The target population will be sampled from the population register for invitees and controls by municipality and by birthcohort. The non-invited controls will gradually be screened only after the six-year implementation period. After 10 years, the programme covers the entire target population. The effects of screening will be evaluated, comparing the incidence of and mortality from colorectal cancer in thoseinvited to screening with controls. The primary screening test is a biannual guaiac-based FOB test with three test cards for consecutive samples. In September–December 2004, around 5000 test-kits were sent to 22 piloting municipalities. In 2005, the programme expands both among municipalitiesand the target population, resulting in nearly 20,000 individual requests. The implementation of colorectal cancer screening in Finland in this way meets the criteria for a randomized controlled trial and the requirements for a public health programme. It allows unbiased research data to becollected while introducing the programme and may set an example for the introduction of all national screening programmes.

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Okoroiwu, G. I. A., I. L. Okoroiwu, N. I. Ubosi, and N. M. Sani. "Sero-prevalence of and risk factors associated with Helicobacter pylori infections among individuals with peptic ulcer in Owerri, Imo State, Nigeria during 2020-2021." African Journal of Clinical and Experimental Microbiology 23, no. 3 (June 17, 2022): 238–47. http://dx.doi.org/10.4314/ajcem.v23i3.3.

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Background: Helicobacter pylori, which is a causative agent of chronic gastritis, duodenal ulcer and gastric cancer, presently affects approximately one half of the world population. This study was conducted to assess the epidemiology and risk factors for acquisition of H. pylori among individuals with and without peptic ulcer symptoms in Owerri, Nigeria, in order to provide baseline data and create awareness for effective management and prevention of infection caused by this pathogen. Methodology: A total of 384 participants, symptomatic and asymptomatic for peptic ulcer, were recruited from the three Local Government Areas (LGAs) of Owerri, Imo State, Nigeria. The symptomatic participants were randomly recruited among patients attending outpatient clinics with symptoms of peptic ulcer disease at the Federal Medical Center Owerri, general hospitals and primary healthcare centers across Owerri LGAs, while asymptomatic patients were recruited from the community. Information on socio-demographic characteristics of each participant and potential risk factors were collected with a pre-tested structured questionnaire. Blood samples were collected for detection of antibodies (IgG) using a one-step H. pylori test device while faecal samples were collected for detection of occult blood (from peptic ulceration) using faecal occult blood (FOB) test. Data were analyzed using SPSS version 25.0 and association of risk factors with H. pylori sero-prevalence was determined by the Chi-square or Fisher Exact test (with Odds ratio). P value < 0.05 was considered statistically significant. Results: The sero-prevalence of H. pylori infection among the study participants was 72.4% (285/384) while the prevalence of ulcer by FOB test was 71.1% (273/384). A total of 78.4% (214/273) of those with ulcers were seropositive for H. pylori while 64.0% (71/111) of those without ulcers were sero-positive for H. pylori (p=0.0045). Factors significantly associated with high sero-prevalence of H. pylori were age groups 41-50 (100%), 21-30 (78.4%) and 31-40 (67.6%) years (X2=66.964, p<0.0001), illiteracy (OR=6.888, p<0.0001), unemployment (OR=2.427, p<0.0001), low social class status (X2=28.423, p=0.0003), drinking of unclean water (OR=5.702, p<0.0001), living in crowded rooms (OR=2.720, p<0.0001), eating food bought from food vendors (OR=3.563, p<0.0001), family history of ulcer (OR=12.623, p<0.0001), habits of eating raw vegetables and unwashed fruits (OR=6.272, p<0.0001), non-regular hand washing practices before meal (OR=2.666, p<0.0001) and presence of ulcer (OR=2.043, p=0.0045). However, smoking (OR=0.7581, p=0.2449) and gender (OR=0.6538, p=0.0796) were not significantly associated with sero-prevalence of H. pylori. Conclusion: There is need for comprehensive strategy including public health education campaign to create awareness on H. pylori, improve personal hygiene and environmental sanitation, provision of safe drinking water by the government to the populace, and discourage indiscriminate and open defecation.

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Federman, Daniel G. "Fecal Occult Blood Test (FOBT) Overuse." Journal of General Internal Medicine 28, no. 5 (March 2, 2013): 610. http://dx.doi.org/10.1007/s11606-013-2396-2.

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Partin, Melissa R., Adam A. Powell, and James F. Burgess. "Fecal Occult Blood Test (FOBT) Overuse." Journal of General Internal Medicine 28, no. 5 (March 9, 2013): 611. http://dx.doi.org/10.1007/s11606-013-2397-1.

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Clark, Gavin, Judith A. Strachan, Frank A. Carey, Thomas Godfrey, Audrey Irvine, Alisson McPherson, Jess Brand, Annie S. Anderson, Callum G. Fraser, and Robert JC Steele. "Transition to quantitative faecal immunochemical testing from guaiac faecal occult blood testing in a fully rolled-out population-based national bowel screening programme." Gut 70, no. 1 (March 31, 2020): 106–13. http://dx.doi.org/10.1136/gutjnl-2019-320297.

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ObjectiveFaecal immunochemical tests (FIT) are replacing guaiac faecal occult blood tests (FOBT) in colorectal cancer (CRC) screening. Data from the first year of FIT screening were compared with those from FOBT screening and assumptions based on a pilot evaluation of FIT.DesignData on uptake, positivity, positive predictive value (PPV) for CRC and higher-risk adenoma from participants in the first year of the FIT-based Scottish Bowel Screening Programme (n=919 665), with a threshold of 80 µg Hb/g faeces, were compared with those from the penultimate year of the FOBT-based programme (n=862 165) and those from the FIT evaluation (n=66 225).ResultsOverall, uptake of FIT was 63.9% compared with 56.4% for FOBT. Positivity was 3.1% and 2.2% with FIT and FOBT; increases were seen in both sexes, and across age range and deprivation. More CRC and adenomas were detected by FIT, but the PPV for CRC was less (5.2% with FIT and 6.4% with FOBT). However, for higher-risk adenoma, PPV was greater with FIT (24.3% with FIT and 19.3% with FOBT). In the previous FIT evaluation, uptake was 58.5% with FIT compared with 54.0% with FOBT; positivity was 2.5% with FIT and 2.0% with FOBT.ConclusionTransition to FIT from FOBT produced higher uptake and positivity with lower PPV for CRC and higher PPV for adenoma. The FIT pilot evaluation underestimated uptake and positivity. Introducing FIT at the same threshold as the evaluation caused a 67.2% increase in colonoscopy demand instead of a predicted 10%.

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Richardson, L. C., and Z. Berkowitz. "Adequacy of follow-up after an abnormal fecal occult blood test (FOBT) result." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 6035. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.6035.

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6035 Background: Annual fecal occult blood testing (FOBT) is the only colon cancer screening shown to reduce colon cancer incidence and mortality in randomized controlled trials. The true benefits of screening are only realized when total colon examination (TCE) is performed as follow-up to an abnormal screening result. Methods: We used the 2000 National Health Interview Survey (NHIS) Cancer Control Supplement, a nationally representative sample of households, to examine follow-up after abnormal FOBT and the content of this follow-up. Persons who reported undergoing an FOBT were the population of interest. Reasons for FOBT, results of test, and follow-up after an abnormal FOBT were examined. Inadequate follow-up after a positive FOBT included no follow-up or another FOBT. TCE was defined as sigmoidoscopy with double contrast barium enema (DCBE) or colonoscopy. We used SUDAAN to obtain population estimates. Results: We included 4,908 respondents who indicated they had undergone FOBT (79.8% as part of the routine physical examination, 14.7% for a specific problem, 2.0% as follow-up of a previous abnormal test/screening examine, 1.4% family history). Overall, 5.7% of respondents reported an abnormal test, varying by reason for test (3.5% for screening and 16.9% for those who had FOBT done for a specific problem). For those reporting an abnormal FOBT during screening, 62.9% had some follow-up diagnostic procedures. Fifty-three percent reported having a TCE as defined above. Forty-seven percent either had no further evaluation, another FOBT or incomplete colon examination with sigmoidoscopy alone, and DCBE only or a surgical evaluation. Those who had FOBT completed for a specific problem had more surgical evaluations (18.4%) and fewer TCEs (44.3%). Conclusions: Among a nationally-representative sample of adults who reported FOBT as a screening test for colorectal cancer, close to 63% had some type of follow-up. Only 53% of those with a positive screening FOBT had a TCE. These results suggest that the full potential of CRC screening is not being realized, and point to the need to improve follow-up of abnormal FOBT results. No significant financial relationships to disclose.

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Ip, Stephen, AbdulRazaq AH Sokoro, Lisa Kaita, Claudia Ruiz, Elaine McIntyre, and Harminder Singh. "Use of Fecal Occult Blood Testing in Hospitalized Patients: Results of an Audit." Canadian Journal of Gastroenterology and Hepatology 28, no. 9 (2014): 489–94. http://dx.doi.org/10.1155/2014/697103.

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BACKGROUND: The fecal occult blood test (FOBT), widely used as a colorectal cancer screening tool, continues to be used in hospitalized patients. However, the utility of this test for hospitalized patients is unclear.OBJECTIVE: To assess FOBT use in a large urban regional health authority.METHODS: Reports of all FOBTs performed between April 1, 2011 and March 30, 2012 from two academic and four community hospitals in Winnipeg (Manitoba) were extracted. Of 650 hospitalizations with a positive FOBT result and 1254 with a negative FOBT result, random samples of 230 and 97 charts, respectively, were reviewed. Information including demographics, admission diagnos(es), indication(s) for ordering the FOBT and clinical management was extracted.RESULTS: Thirty-four percent (650 of 1904) of hospitalizations with an FOBT had a positive FOBT result. Family medicine physicians ordered approximately one-half of the reviewed FOBTs. The most common indication for ordering an FOBT was anemia. Of those with a positive FOBT, 66% did not undergo further gastrointestinal investigations. Of those with a positive FOBT and overt gastrointestinal bleeding and/or melena who underwent endoscopy, 60% had their endoscopy performed before the FOBT result being reported while 38% underwent their endoscopy ≥3 days after the stool sample was collected. There were minimal differences in clinical practices between academic and community hospitals.CONCLUSIONS: The present study suggests that FOBT results in hospitalized patients may have little beneficial impact on clinical management. Hospital laboratories may be better served in directing resources to other tests.

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Journal articles on the topic 'Faecal occult blood test (FOBT)'

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