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Comparison of Fecal Occult Blood Tests for Colorectal Cancer Screening in an Alaska Native Population With High Prevalence of Helicobacter pylori Infection, 2008–2012
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Apr 10 2014
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Source: Prev Chronic Dis 11
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Journal Article:Preventing Chronic Disease (PCD)
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Personal Author:
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Description:Introduction
Alaska Native colorectal cancer (CRC) incidence and mortality rates are the highest of any ethnic/racial group in the United States CRC screening using guaiac-based fecal occult blood tests (gFOBT) are not recommended for Alaska Native people because of false-positive results associated with a high prevalence of Helicobacter pylori-associated hemorrhagic gastritis This study evaluated whether the newer immunochemical FOBT (iFOBT) resulted in a lower false-positive rate and higher specificity for detecting advanced colorectal neoplasia than gFOBT in a population with elevated prevalence of H pylori infection
Methods
We used a population-based sample of 304 asymptomatic Alaska Native adults aged 40 years or older undergoing screening or surveillance colonoscopy (April 2008–January 2012)
Results
Specificity differed significantly (P < 001) between gFOBT (76%; 95% CI, 71%–81%) and iFOBT (92%; 95% CI, 89%–96%) Among H pylori-positive participants (54%), specificity of iFOBT was even higher (93% vs 69%) Overall, sensitivity did not differ significantly (P = 73) between gFOBT (29%) and iFOBT (36%) Positive predictive value was 11% for gFOBT and 32% for iFOBT
Conclusion
The iFOBT had a significantly higher specificity than gFOBT, especially in participants with current H pylori infection The iFOBT represents a potential strategy for expanding CRC screening among Alaska Native and other populations with elevated prevalence of H pylori, especially where access to screening endoscopy is limited
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ISSN:1545-1151
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Volume:11
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[PDF-574.94 KB]
