Diagnostic Accuracy for CRC High with Home Stool Test

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Diagnostic Accuracy for CRC High with Home Stool Test
Diagnostic Accuracy for CRC High with Home Stool Test

(HealthDay News) — Fecal immunochemical tests (FITs) have moderate sensitivity, high specificity, and high overall diagnostic accuracy for detecting colorectal cancer (CRC), according to research published in the Feb. 4 issue of the Annals of Internal Medicine.

Jeffrey K. Lee, MD, of the University of California in San Francisco, and colleagues conducted a systematic review and meta-analysis of the literature to assess the diagnostic accuracy of FITs for detecting CRC in asymptomatic, average-risk adults.

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The researchers found that, for CRC screening, the overall diagnostic accuracy of FITs was 95% (95% confidence interval [CI], 93% to 97%), the pooled sensitivity was 0.79 (95% CI, 0.69 to 0.86), and the pooled specificity was 0.94 (95% CI, 0.92 to 0.95). Using a lower assay cutoff value for a positive test result, such as less than 20 µg/g, improved sensitivity to 0.89 (95% CI, 0.80 to 0.95) but decreased specificity.

"FITs are moderately sensitive, are highly specific, and have high overall diagnostic accuracy for detecting CRC. Diagnostic performance of FITs depends on the cutoff value for a positive test result," the researchers concluded.

"Health systems wishing to optimize use of a quantitative FIT should consider the tradeoff between increasing sensitivity (by lowering the cutoff threshold for a positive test) and the resulting increase in the number of positive test results, which will have a greater effect on colonoscopy resources."

References

  1. Lee JK, Liles EG, Bent S, et al. Accuracy of Fecal Immunochemical Tests for Colorectal Cancer: Systematic Review and Meta-analysis. Ann Intern Med. 2014;160(3):171-181-181.

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