Details:

Alternative Title:
Prev Chronic Dis
Publisher's site:
http://dx.doi.org/10.5888/pcd11.130281
Personal Author:
Redwood, Diana ; Provost, Ellen ; Asay, Elvin ; Roberts, Diana ; Haverkamp, Donald ; ... More +
Redwood, Diana ; Provost, Ellen ; Asay, Elvin ; Roberts, Diana ; Haverkamp, Donald ; Perdue, David ; Bruce, Michael G. ; Sacco, Frank ; Espey, David Less -
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.


Subject:
[+]
Adult
Colorectal Neoplasms
Early Detection Of Cancer
Feces
Female
Helicobacter Infections
Helicobacter Pylori
Humans
Indians, North American
Male
Middle Aged
Occult Blood
Original Research

Source:
Prev Chronic Dis. 11.
Document Type:
Journal Article
Place as Subject:
Alaska
Collection(s):
Arctic Investigations Program
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:044cd8e9f5b41bd9f45df756721e8c478b115a8a8b38b570d13de32e465df6ab
File Type:

Supporting Files

• 	license.txt	txt
  	PCD-11-E56.nxml	txt
  	PCD-11-E56s01.gif	gif
  	PCD-11-E56s01.jpg	jpeg

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