Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test

Birkenfeld, Shlomo; Belfer, Rachel Gingold; Chared, Miri; Vilkin, Alex; Barchana, Micha; Lifshitz, Irena; Fruchter, Dana; Aronski, Dina; Balicer, Ran D.; Niv, Yaron; Levi, Zohar

doi:10.1258/jms.2011.010147

Cited by 15 publications

(13 citation statements)

References 31 publications

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“…Again, in these two studies, the uptake for FIT was better: 59.6 and 61.5%. Uptake in our study population was higher in men than in women, in contrast with previously published data from Europe (Steele et al, 2010;Blom et al, 2014) and from Israel (Birkenfeld et al, 2011). The discrepancy between these studies and ours may be because of the characteristics of the study populations.…”

Section: Discussioncontrasting

confidence: 99%

Guaiac faecal occult blood screening in individuals younger than 50 years of age

Zalts¹,

Moadi²,

Avizohar

et al. 2017

European Journal of Cancer Prevention

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To determine the effectiveness of guaiac faecal occult blood tests (gFOBT) in the early detection of colorectal cancer (CRC) within a population of asymptomatic individuals who attended general periodic examinations, and to suggest the recommended age for this screening tool, the electronic database of the periodic examination institute of Rambam Healthcare Campus for the years 2004-2013 was reviewed. Individuals with positive gFOBT results were interviewed for further workup. Proportions of individuals for whom a polyp or CRC was detected were evaluated according to sex and age. 18 858 individuals were examined during the study period, mean age 48 years. The overall gFOBT uptake was 40.8%. Uptake was significantly higher among men and increased with age. Positive gFOBT was detected in 105 individuals (1.4%). The proportion of positive gFOBT was significantly lower among individuals aged 30-50 years than those older than 50 years of age (1.1 and 1.7%, respectively, P=0.005). No positive gFOBT was detected among individuals younger than 30 years of age. Positive gFOBT was higher in men than in women: 1.8 and 0.9% respectively (P=0.002). CRC was detected in six individuals, including two younger than 50 years of age. Polyps were detected in 15 individuals; of these, four were younger than 50 years of age. In the gFOBT-positive group, proportions of polyps and CRC were the same for subgroups according to age. The findings support consideration of annual gFOBT screening from the age of 40 years.

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Section: Discussioncontrasting

confidence: 99%

Guaiac faecal occult blood screening in individuals younger than 50 years of age

Zalts¹,

Moadi²,

Avizohar

et al. 2017

European Journal of Cancer Prevention

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“…In the one RCT that did not observe a difference in uptake between mailed FIT and gFOBT, the FIT procedure was equally if not more demanding than the gFOBT, with the FIT requiring 3 stool samples (similar to the guaiac test) and sample refrigeration (Birkenfeld, et al, 2011). Percent uptake differs considerably among trials, ranging from 30-40% in an Australian study to 50-70% in a Veterans Affairs study.…”

Section: Discussionmentioning

confidence: 99%

Uptake and positive predictive value of fecal occult blood tests: A randomized controlled trial

Chubak

Bogart

Fuller

et al. 2013

Preventive Medicine

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Objective To compare the uptake of three mailed high-sensitivity fecal occult blood tests (FOBTs). Methods We conducted a parallel 3-arm randomized controlled trial in an integrated healthcare delivery system in Washington State. From January 2010 through February 2011, automated data were used to identify potentially eligible patients aged 50-74 due for colorectal cancer screening. Participants were mailed one of three FOBT kits (1-sample OC-Auto® fecal immunochemical test [FIT], 2-sample InSure® FIT, or 3-sample guaiac Hemoccult SENSA®), instructions, and a postage-paid return envelope. We performed a modified intent-to-treat analysis with return of any FOBT within 6 months of randomization as the primary outcome. Results Of the 9922 people invited, 2873 returned surveys, 2263 were randomized, and 2234 were analyzed. FOBTs were returned by 1431 participants. At 6 months post randomization, the proportions screened by any FOBT were 0.69 (95% confidence interval [CI] 0.66-0.72) for the OC-Auto arm, 0.64 (95% CI: 0.61-0.68) for the InSure arm, and 0.61 (95% CI: 0.58-0.65) for the Hemoccult SENSA arm (P < 0.001 for any difference). Pairwise comparisons showed significant differences between the OC-Auto group and each of the other groups after correction for multiple comparisons. Conclusion Uptake of mailed FOBT kits varies by kit type.

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“…17 A single spot urine-based test that accurately detects colonic adenomatous polyps would markedly improve adherence in screening programs.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Highly Sensitive Urine-Based Test to Identify Patients with Colonic Adenomatous Polyps

Wang

Tso

Wong

et al. 2014

Clinical and Translational Gastroenterology

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Objectives:Adenomatous polyps are precursors of colorectal cancer; their detection and removal is the goal of colon cancer screening programs. However, fecal-based methods identify patients with adenomatous polyps with low levels of sensitivity. The aim or this study was to develop a highly accurate, prototypic, proof-of-concept, spot urine-based diagnostic test using metabolomic technology to distinguish persons with adenomatous polyps from those without polyps.Methods:Prospective urine and stool samples were collected from 876 participants undergoing colonoscopy examination in a colon cancer screening program, from April 2008 to October 2009 at the University of Alberta. Colonoscopy reference standard identified 633 participants with no colonic polyps and 243 with colonic adenomatous polyps. One-dimensional nuclear magnetic resonance spectra of urine metabolites were analyzed to define a diagnostic metabolomic profile for colonic adenomas. A urine metabolomic diagnostic test for colonic adenomatous polyps was established using 67% of the samples (un-blinded training set) and validated using the other 33% of the samples (blinded testing set). The urine metabolomic diagnostic test's specificity and sensitivity were compared with those of fecal-based tests.Results:Using a two-component, orthogonal, partial least-squares model of the metabolomic profile, the un-blinded training set identified patients with colonic adenomatous polyps with 88.9% sensitivity and 50.2% specificity. Validation using the blinded testing set confirmed sensitivity and specificity values of 82.7% and 51.2%, respectively. Sensitivities of fecal-based tests to identify colonic adenomas ranged from 2.5 to 11.9%.Conclusions:We describe a proof-of-concept spot urine-based metabolomic diagnostic test that identifies patients with colonic adenomatous polyps with a greater level of sensitivity (83%) than fecal-based tests.

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Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test

Cited by 15 publications

References 31 publications

Guaiac faecal occult blood screening in individuals younger than 50 years of age

Guaiac faecal occult blood screening in individuals younger than 50 years of age

Uptake and positive predictive value of fecal occult blood tests: A randomized controlled trial

Development and Validation of a Highly Sensitive Urine-Based Test to Identify Patients with Colonic Adenomatous Polyps

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