Screening for Colorectal Cancer by Fecal Occult Blood Testing

Abstract

Backg round and aim of work: Colorectai ca n cer (CRC) is a major cause of cancer mortality a nd morbidity world wide yet it is considered a preven table disease. Screening asy mptomatic persons by fecal occult blood test (FOBT) can red uce mortality from CRC. This prospecti ve stud y was designed to assess lhe val ue of FOBT screening in the Egy ptian population. Patients and methods: Patients were recruited as follows: Group 1 included 42 asymptomatic individua ls who participa ted in a screening program of FOBT and colonoscopy while the other grou ps i ncluded 70 patients referred for colonoscopy. Patients were subjected to colonoscopy and find ings were correlated with two different ty pes of FOBT: Guaiac-based and immunochemical tests. Results: 31 cases of CRC and 22 cases wi th polyps were detected. 33

patients had normal colonoscopic findings. i FOBT was positi ve in 45 cases and negati ve in 55 cases wi th a sensitivity of 69% and a specifi city of 86% while gFOBT was positi ve i n 58 cases and negati ve in 42 case wi th a sensiti v it y of 78% and a specificity of 82% for al! l esions. g FOBT had a sensiti vit y of 93% for CRC and 45% for adeno matous pol yps while i FOBT was 87% a nd 36% respecti vel y. Conclusirms: FOBT prov ides a n acceptable screeni ng method for CRC. iFOBT i a more speci(ic test for screenin g than gFOBT but has a lower St> ns: iYity in lha t r spect.