Reduction in risk of mortality from colorectal cancer by fecal occult blood screening with immunochemical hemagglutination test. A case‐control study

Abstract

Fecal occult blood testing by immunochemical hemagglutination has been shown to be superior to the Hemoccult test, both in sensitivity and in specificity. The test has been widely used as a tool for population screening in Japan, but there has been no study to evaluate the efficacy of screening using this test. A case-control study to evaluate the screening was conducted in study areas where no previous and no other concomitant colorectal cancer screening had been performed. Case series in the study were 193 cases who died of colorectal cancer. Three controls were selected randomly from the list of individuals who were alive at the time of diagnosis of the corresponding case and had been living in the same area as the case, matched by gender and by age. Odds ratios (OR) of dying of colorectal cancer for those screened within 1, 2 and 3 years of case diagnosis vs. those not screened were 0.40 [95% confidence interval (CI) 0.17-0.92], 0.41 (95% CI 0.20-0.82), and 0.48 (95% CI 0.25-0.92), respectively. OR increased towards 1.0 as the duration during which screening histories were compared was extended, and showed similar tendencies when analyzed by number of years since the most recent screening history. These results suggest that colorectal cancer screening by the immunochemical fecal occult blood test would reduce mortality from colorectal cancer.

A new insight into fecal hemoglobin concentration‐dependent predictor for colorectal neoplasia

“…While the fecal immunochemical test (FIT) is widely used in population-based screening for colorectal neoplasia and is effective in reducing colorectal cancer mortality through early detection, [1][2][3][4][5][6][7][8][9][10][11][12] it has been not yet known whether the detailed information on quantitative fecal hemoglobin concentration (FHbC) available with the FIT might also be of use for predicting the risk of colorectal neoplasia. Unfortunately, because clinical practice is to select subjects with FHbC greater than a set cut-off for further clinical investigation the precise value of FHbC, although measured and often reported, is largely neglected.…”

Association of FOBT-assessed faecal Hb content with colonic lesions detected in the Florence screening programme

“…Screening by faecal occult blood testing (FOBT) has been shown to be effective in reducing colorectal cancer (CRC) mortality (Mandel et al, 1993;Selby et al, 1993;Saito et al, 1995;Hardcastle et al, 1996;Kronborg et al, 1996;Castiglione et al, 1997;Bertario et al, 1999;Mandel et al, 2000), and population-based screening is currently recommended by the European Community (Advisory Committee on Cancer Prevention, 2000) and is under implementation in several countries, including Italy (Zorzi et al, 2006) (www. osservatorionazionalescreening.it).…”

Immunochemical vs guaiac faecal occult blood tests in a population-based screening programme for colorectal cancer

“…In the above-mentioned study rehydrated Hemoccult shows a high sensitivity for CRC (92.2%) but the corresponding specificity value is disappointingly low (90.4%), causing a high referral rate to colonoscopy (9.8%) and a relevant increase in screening costs. Another test, Hemeselect (SmithKline Diagnostics, San Jose, CA, USA), based on reverse-passive haemagglutination, has been (found to show) increased sensitivity as compared with Hemoccult (Castiglione et al, 1992;St John et al, 1993;Petrelli et al, 1994;Castiglione et al, 1994;Robinson et al, 1994) and also evidence of effectiveness in reducing mortality from CRC (Saito et al, 1995). In our preliminary experiment (Castiglione et al, 1992; 38% and 48% (mean=44%).…”