Testing for faecal calprotectin (PhiCal) in the Norwegian Colorectal Cancer Prevention trial on flexible sigmoidoscopy screening: comparison with an immunochemical test for occult blood (FlexSure OBT)
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Summary
This summary is machine-generated.The fecal calprotectin (PhiCal) test showed poorer performance than the FlexSure OBT for colorectal cancer screening. FlexSure OBT is recommended for FOBT screening, while PhiCal is not suitable for population screening.
Area Of Science
- Gastroenterology
- Oncology
- Diagnostic Medicine
Background
- Guaiac-based fecal occult blood tests (FOBT) have limited sensitivity for asymptomatic colorectal cancer (CRC).
- Improved non-invasive screening tests for CRC are needed.
- Faecal calprotectin (PhiCal) and immunochemical FOBT (FlexSure OBT) were compared.
Purpose Of The Study
- To compare the diagnostic performance of fecal calprotectin (PhiCal) and immunochemical FOBT (FlexSure OBT) for colorectal cancer screening.
- To evaluate the utility of PhiCal for detecting colorectal neoplasia.
Main Methods
- The Norwegian Colorectal Cancer Prevention (NORCCAP) trial involved 2321 screenees.
- Participants underwent flexible sigmoidoscopy and FlexSure OBT.
- Stool samples were tested using the PhiCal assay, with a positive threshold of >=50 microg/g.
Main Results
- PhiCal positivity was 24-27% across different adenoma risk groups.
- Ten of 16 CRCs (63%) were positive by PhiCal.
- PhiCal sensitivity for advanced neoplasia was 27% vs. 35% for FlexSure OBT; specificity was 76% vs. 90%.
Conclusions
- The PhiCal test demonstrated poorer performance than FlexSure OBT in a single screening round.
- PhiCal is not recommended for population-based colorectal cancer screening.
- FlexSure OBT shows potential for FOBT screening programs.