Skip to main content
SpringerLink
Log in

Performance Characteristics and Comparison of Two Fecal Occult Blood Tests in Patients Undergoing Colonoscopy

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

We investigated the use of a new type of FOBT (EZ-Detect) that uses the blood's pseudo-peroxidase activity as an enzymatic catalyst, in a one-step chromogen-substrate system performed by the patient. Asymptomatic patients ≥50 years old received three Hemoccult II (HO) cards and three EZ-Detect (EZ) packages to be used in three consecutive bowel movements. Sensitivity, specificity, positive predictive value, and negative predictive value for detection of colorectal neoplasia was calculated. The study included 207 patients, with a mean age of 58.9 years. Diagnostic accuracy for detection of adenomas was similar for the EZ and HO tests (66.7% vs. 71.0%; P=0.48), while for advanced adenomas diagnostic accuracy for the EZ and HO tests was 86.0% vs. 94.2% (P=0.01), respectively. Most patients preferred the EZ test (92% vs. 8%). We conclude that the EZ test has a diagnostic profile similar to that of the HO test for identification of adenomas; however, for advanced adenomas the diagnostic accuracy was slightly better for the HO. The EZ test was preferred by most patients, which may increase colorectal cancer screening compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bresalier RS, Kim YS (1998) Malignant neoplasms of the large intestine. In: Feldman M, Sleisenger MH, Scharschmidt BF, (eds.) Gastrointestinal disease, 6th ed. WB Saunders, Philadelphia, pp 1906–1939

    Google Scholar 

  2. Kronborg O, Fenger C, Olsen J, et al. (1996) Randomized study of screening for colorectal cancer with faecal-occult-blood test. Lancet 348:1467–1471

    Article  PubMed  CAS  Google Scholar 

  3. Allison JE (2005) Colon cancer screening guidelines 2005: The fecal occult blood test option has become a better FIT. Gastroenterology 129:745–748

    Article  PubMed  Google Scholar 

  4. Mandel JS, Bond JH, Church TR, et al. (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 328:1365–1371

    Article  PubMed  CAS  Google Scholar 

  5. Hardcastle JD, Chamberlain JO, Robinson MH, et al. (1996) Randomized controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 348:1472–1477

    Article  PubMed  CAS  Google Scholar 

  6. Mandel JS, Church TR, Bond JH, et al. (2000) The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 343:1603–1607

    Article  PubMed  CAS  Google Scholar 

  7. Liberman D, Sleisenger MH (1996) It is time to recommend screening for colorectal cancer? Lancet 348:1463–1464

    Article  Google Scholar 

  8. Liberman DA (1990) Colon cancer screening. The dilemma of positive screening tests. Arch Intern Med 150:740–744

    Article  Google Scholar 

  9. Greenberg PD, Bertario L, Gnauck R, et al. (2000) A prospective multicenter evaluation of new fecal occult blood tests in patients undergoing colonoscopy. Am J Gastroenterol 95:1331–1338

    Article  PubMed  CAS  Google Scholar 

  10. Collins JF, Lieberman DA, Durbin TE, et al. (2005) Veterans Affairs Cooperative Study #380 Group. Accuracy of screening for fecal occult blood on a single stool sample obtained by digital rectal examination: a comparison with recommended sampling practice. Ann Intern Med 142(2):81–85

    PubMed  Google Scholar 

  11. Tate JJ, Northway J, Royle GT, et al. (1989) Evaluation of a “DIY” test for the detection of colorectal cancer. J R Soc Med 82:388–390

    PubMed  CAS  Google Scholar 

  12. Hou SI, Chen PH (2004) Home-administered fecal occult blood test for colorectal cancer screening among worksites in Taiwan. Prev Med 38:78–84

    Article  PubMed  Google Scholar 

  13. Ahlquist DA, Wieand HS, Moertel CG, et al. (1993) Accuracy of fecal occult blood screening for colorectal neoplasia. A prospective study using Hemoccult and HemoQuant test. JAMA 269:1262–1267

    Article  PubMed  CAS  Google Scholar 

  14. St John DJB, Young GP, Alexeyeff MA, et al. (1993) Evaluation of new occult blood tests for detection of colorectal neoplasia. Gastroenterology 104:1661–1668

    PubMed  CAS  Google Scholar 

  15. Smith RA, Cokkinindes V, Eyre HJ (2004) American Cancer Society guidelines for early detection of cancer. Ca Cancer J Clin 54(1):41–52

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Grant K07 CA092445 (to M.C.C.) and supported in part by an unrestricted grant from the Sol Hubert Trust (supplied EZ-Detect packages). None of the authors are on the Advisory Boards or Speaker Bureaus for the Sol Hubert Trust.

Author information

Authors and Affiliations

  1. Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 420, Baltimore, Maryland, 21205, USA

    Marcia Cruz-Correa, Kathleen Schultz, Sanjay Jagannath, Mary Harris, Sergey Kantsevoy, Marshall Bedine & Anthony N. Kalloo

  2. Department of Medicine, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico, 00936, USA

    Marcia Cruz-Correa

Authors
  1. Marcia Cruz-Correa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathleen Schultz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sanjay Jagannath
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mary Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sergey Kantsevoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marshall Bedine
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anthony N. Kalloo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony N. Kalloo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cruz-Correa, M., Schultz, K., Jagannath, S. et al. Performance Characteristics and Comparison of Two Fecal Occult Blood Tests in Patients Undergoing Colonoscopy. Dig Dis Sci 52, 1009–1013 (2007). https://doi.org/10.1007/s10620-006-9383-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9383-y

Keywords

Search

Navigation