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Published on: August 1, 2019
[Comparison of three FOBT protocols for colorectal cancer screening in Chinese--a multicenter study]
Shi-Rong Li1, Hua-Hong Wang, Ji-Chun Hu
1Department of Gastroenterology, Beijing Army General Hospital, Beijing 100700, China.
Objective:
To evaluate three FOBT protocols of colorectal cancer screening.
Methods:
A multycenter study was conducted based on a consulted program. The effectiveness/cost of each protocole (CFOBT, IFOBT, SFOBT) were evaluated by the identifying patients who underwent CFOBT and IFOBT for 3 times consecutively as well as colonoscopy.
Results:
323 eligible patients including 49 colorectal cancers, 60 colon adenomas, 60 chronic colitis, 15 hemorrhoids and 139 normal colon were observed. The effect/cost of CRC screening protocols was following: 1). For 3 times of FOBT consecutively: There was no significant difference for their sensitivity among CFOBT, IFOBT and SFOBT (95.9%, 95.9% & 93.9%) but the specificity of IFOBT and SFOBT (89.21% and 94.24%) were higher significantly than CFOBT (75.54%). The specificity of SFOBT was higher than IFOBT. After adjusting their detecting number of cancer to same level the cost of SFOBT was the lowest. among these FOBTs.2). For 2 times of FOBT consecutively: The sensitivity of CFOBT, IFOBT and SFOBT were 77.8%, 87.8% and 75.5% respectively. The sensitivity of IFOBT was higher than SFOBT and CFOBT significantly. Their specificity were 88.5%, 96.4% and 98.6% respectively. The specificity of IFOBT and SFOBT were higher significantly than CFOBT. However, there was no significant difference for the specificity between IFOBT and SFOBT. After adjusting their detecting number of cancer to same level the cost of IFOBT was the lowest. among these FOBTs.3). The detected rate of early colorectal cancer was 60% for all of 3 protocols. 4). 41.6% approximately 48.3% of adenomas was found by the 3 protocols, and 87.5% of adenomas over 2 cm in diameter were detected by any one of FOBT.
Conclusions:
For the population with nice compliance 3 times of SFOBT will be recommended as a screening protocol of colorectal cancer. For that with poor compliance 2 times of IFOBT was recommended 3. The majority of adenomas in that advanced lesion existed might be detected by FOBT.
