摘要
Background We aimed to improve the sensitivity of immunochemical fecal occult blood test （I-FOBT） to screen colorectal neoplasm among average-risk adults. Methods This is a diagnostic cohort study. All health examination participants receiving a single qualitative I-FOBT and a screening colonoscopy from January 2010 to June 2011 were included. Stool specimens were collected for I-FOBT before colonoscopy. Using pathology as gold standard, significant colorectal neoplasm was defined as advanced adenoma or malignancy. Results A total of 1 007 health examinees were identified. Fifty-five （5.5%） had borderline positive （＋/-） I-FOBT, while 38 （3.8%） had positive I-FOBT. Twenty-four （2.4%） had advanced adenoma, and five （0.5%） had carcinoma. Using borderline positive I-FOBT as cutoff value, the sensitivity and specificity for significant colorectal neoplasm were 34.5% （95% confidence interval （CI） 19.9%-52.7%） and 91.5% （95% CI 89.6%-93.1%）, respectively. If combined with advanced age, high blood pressure （BP）, and abdominal obesity, a fulfillment of either two criteria further increased the sensitivity to 72.4% （95% CI 54.3%-85.3%） with a specificity of 68.8% （95% C165.8%-71.6%）. Conclusion The sensitivity of a single qualitative I-FOBT for the detection of significant colorectal neoplasm can be increased by coupling with age, BP, and abdominal obesity.
Background We aimed to improve the sensitivity of immunochemical fecal occult blood test （I-FOBT） to screen colorectal neoplasm among average-risk adults. Methods This is a diagnostic cohort study. All health examination participants receiving a single qualitative I-FOBT and a screening colonoscopy from January 2010 to June 2011 were included. Stool specimens were collected for I-FOBT before colonoscopy. Using pathology as gold standard, significant colorectal neoplasm was defined as advanced adenoma or malignancy. Results A total of 1 007 health examinees were identified. Fifty-five （5.5%） had borderline positive （＋/-） I-FOBT, while 38 （3.8%） had positive I-FOBT. Twenty-four （2.4%） had advanced adenoma, and five （0.5%） had carcinoma. Using borderline positive I-FOBT as cutoff value, the sensitivity and specificity for significant colorectal neoplasm were 34.5% （95% confidence interval （CI） 19.9%-52.7%） and 91.5% （95% CI 89.6%-93.1%）, respectively. If combined with advanced age, high blood pressure （BP）, and abdominal obesity, a fulfillment of either two criteria further increased the sensitivity to 72.4% （95% CI 54.3%-85.3%） with a specificity of 68.8% （95% C165.8%-71.6%）. Conclusion The sensitivity of a single qualitative I-FOBT for the detection of significant colorectal neoplasm can be increased by coupling with age, BP, and abdominal obesity.
