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PubMed1987

Screening for colorectal neoplasms. A comparison of the fecal occult blood test and endoscopic examination.

Testing for occult blood in stool is used frequently as a screening technique for colorectal carcinomas, but no study has ever shown an improved survival rate for colorectal carcinoma in patients screened by this method. Consequently, the authors have prospectively compared the sensitivity of endoscopy and occult blood testing in finding colorectal neoplasms. During the first year of the Surgical Endoscopy Service, 585 patients underwent sigmoidoscopy or colonoscopy. Seventy-nine patients (13.5 percent) were excluded from the study because their occult blood status was not recorded. Patients averaged 63 + 10 years of age and 98 percent were men. Of the 348 patients with occult blood negative stools 55.5 percent underwent colonoscopy and 44.5 percent underwent sigmoidoscopy. Polyps were found in 25.6 percent of these patients, colorectal carcinomas in 2.6 percent, and diverticulosis 36.2 percent. Of the 158 patients with occult blood positive stool, 76.5 percent underwent colonoscopy and 23.4 percent underwent sigmoidoscopy. Polyps were discovered in 39.0 percent of these patients, colorectal carcinomas in 10.1 percent, and diverticulosis in 43.0 percent. Thus, the occult blood test was negative in 59 percent of patients with polyps and 36 percent with colorectal cancers. These data indicate that lower gastrointestinal endoscopy is superior to occult blood testing in detecting colorectal neoplasms. These results further suggest that using the occult blood test as a screening test for colorectal neoplasms will result in a significant number of these lesions being missed at an early curable stage.

Aged↗
PubMed1987

[Comparison of chemical and immunological methods in fecal occult blood testing].

Conventional occult blood testing using the chemical method has been compared with newly developed immunological testing methods; the Hemoccult slide II (HEM II) test has been widely accepted as a guaiac test but such recent tests as the Latex agglutination test (Latex) and the Enzyme Immunoassay method (EIA) have also come to be employed. Thirty colorectal cancer patients, 30 gastric cancer patients and 30 healthy persons were subjected the three above described tests during 3 consecutive days while under no restricted diet. False positive rates during this three-day testing period were 26.7% in HEM II, 93.3 in Late and 8.3% in EIA. Although the immunological testing method has the advantage of reducing the false positive rate without the need for a restricted diet it is time-consuming and expensive. Considering these results as well as our previous knowledge accrued from a mass survey, it is suggested that a new flow-chart may be found necessary, in which an initial screening is given by the chemical method and then followed by a secondary screening by the immunological method. This new flow-chart, if routinely employed, would greatly facilitate the mass screening of colorectal cancer.

Hemoglobins↗
PubMed2006

A quantitative immunochemical faecal occult blood test is more efficient for detecting significant colorectal neoplasia than a sensitive guaiac test.

BACKGROUND: The sensitive guaiac faecal occult blood test, Haemoccult SENSA (HOS; Beckman Coulter, Fullerton, CA, USA), is our standard screening test for significant colorectal neoplasia. We evaluated an automatically-developed, quantified human haemoglobin immunochemical faecal test, OC-MICRO (Eiken Chemical Co., Tokyo, Japan), to improve test specificity and so reduce the colonoscopy burden. AIM: To compare guaiac faecal occult blood test and immunochemical faecal test diagnostic efficacy and costs for identifying significant neoplasia. METHODS: Colonoscopies were performed on patients who prepared three daily guaiac faecal occult blood tests with or without immunochemical faecal tests. RESULTS: Total colonoscopy was performed on 151 subjects who prepared both guaiac and immunochemical faecal tests (group 1) and the positive predictive values (PPV) were also compared to those of 162 subjects undergoing colonoscopy for positive guaiac faecal occult blood tests (group 2). In group 1, comparative sensitivity, specificity, and PPVs for significant neoplasia with guaiac faecal occult blood test were 75%, 34%, and 12% (PPV, 18% for group 2) and with immunochemical faecal test were 75%, 94% and 60% (P < 0.01 for specificity). The number of colonoscopy examinations needed to detect a significant neoplasm because of positive faecal occult blood tests was six to eight with HOS and two with OC-MICRO at 21-31% the cost of evaluating a positive guaiac faecal occult blood test. CONCLUSION: An immunochemical faecal test maintains the high sensitivity of guaiac faecal occult blood test, but significantly reduces the colonoscopy burden and screening costs.

Aged↗
PubMed1990

Comparison of Coloscreen Self-Test and Haemoccult faecal occult blood tests in the detection of colorectal cancer in symptomatic patients.

The usefulness of faecal occult blood tests is limited by their acceptability to patients. Standard tests require the collection of a stool sample which may inhibit compliance. Self-read tests which avoid this step have therefore been devised. Coloscreen Self-Test (CST) and Haemoccult, which may be regarded as the standard slide test, were offered to 450 consecutive patients attending surgical outpatient clinics with symptoms suggestive of lower gastrointestinal disease. Both tests were successfully completed by 383 patients. Although 262 (68 per cent) patients indicated that they preferred CST this was not reflected in the overall compliance to the two tests (CST 86 per cent, Haemoccult 90 per cent). CST gave a positive result in only eight out of 24 patients with a colorectal cancer (sensitivity = 33 per cent) compared with 13 out of 24 for Haemoccult (sensitivity = 54 per cent). CST had no advantage from increased compliance to outweigh its lower sensitivity.

Colorectal Neoplasms↗
PubMed2005

Evaluation of the Ez-HBT Helicobacter blood test to establish Helicobacter pylori eradication.

BACKGROUND: The urea blood test (Ez-HBT) has been shown to compare favourably with the urea breath test in the diagnosis of active Helicobacter pylori infection. AIM: To examine the performance characteristics of the Ez-HBT Helicobacter blood test in establishing success or failure of therapy in H. pylori-infected adults using the 13C urea breath test as the reference method. METHODS: 13C urea breath test and Ez-HBT Helicobacter blood test were performed 4-6 weeks after completion of treatment in H. pylori positive subjects. Basal urea breath samples were collected; basal Ez-HBT Helicobacter blood test samples were not. Ez-HBT Helicobacter blood test results were reported as positive, negative, or indeterminate. RESULTS: Seventy patients generated 126 measurable sets of urea breath and blood tests. The H. pylori cure rate was 93%. The sensitivity, specificity, and accuracy of the Ez-HBT Helicobacter blood test were 100%, 97%, and 97%, respectively. Six of eight false positive and indeterminate Ez-HBT Helicobacter blood test results could be attributed to incomplete fasting or a 13C enriched diet. After correcting for the non-fasting state, the positive predictive value of the Ez-HBT Helicobacter blood test improved from 56% to 86%. CONCLUSION: The performance characteristics of the Ez-HBT Helicobacter blood test are comparable with that of 13C-urea breath test in establishing H. pylori eradication after therapy. Errors related to incomplete fasting can be mitigated by collection of a basal blood sample.

Adult↗
PubMedDate not supplied

Pleuropneumonia caused by Haemophilus parahaemolyticus. An attempt to control the disease at two progeny testing stations by serological blood testing followed by removal of the seropositive animals and their litter mates.

The complement fixation test was employed at two progeny testing stations in an attempt to avoid outbreaks of contagious pleuropneumonia, caused by Haemophilus parahaemolyticus. Pigs were isolated immediately after arrival at the testing stations and blood samples taken for serology. Test groups with seropositive animals were not admitted to the testing station. The sanitation scheme proved successful, in that acute outbreaks were avoided at both stations and the frequency of chronic pleuritis at slaughter fell from appr. 12 per cent to appr. 6 per cent (Station A) and from appr. 8 per cent to appr. 1 per cent (Station B). Accordingly, the complement fixation test may be of value in diagnosing subclinical infections and thus in the control of Haemophilus parahaemolyticus pleuropneumonia.

Animals↗
PubMed2005

Comparison of 13C- urea blood test to 13C-breath test and rapid urease test for the diagnosis of Helicobacter pylori infection.

At present, the available methods to diagnose active H. pylori infection are endoscopy with biopsy for histology, culture, rapid urease tests, 13C or 14C urea breath test, urine antibody and the stool antigen test. The aims of this study were to simplify the 13C urea test by measuring 13C in blood rather than breath, and to evaluate the usefulness of the 13C urea blood test for the diagnosis of H. pylori infection. Patients who underwent upper endoscopy for standard clinical indications (e.g. dyspepsia, abdominal pain) were enrolled. A total of 161 patients (93F, 68M, mean age 47 +/- 14.2) were evaluated; 50 (31%) of them were H. pylori positive, and 111(69%) were H. pylori negative. H. pylori infection was diagnosed with a rapid urease test (CLO-test) and 13C urea breath test (UBT). Performance characteristics for the 13C urea blood test for diagnosis and evaluation of H. pylori eradication were calculated using UBT and CLO as gold standards. The fifty H. pylori-positive patients were treated with triple antibiotic therapy for two weeks. Four weeks after finishing antibiotic therapy patients were retested with a commercial UBT and urea blood test. The 13C blood test had sensitivities of 92 and 98% and specificities of 96 and 100% as compared with urea breath test and CLO, respectively. We conclude that the 13C urea blood test is highly sensitive and specific for the initial diagnosis and control of eradication of H. pylori infection.

Adolescent↗
PubMed1994

Diagnosis of tuberculosis due to Mycobacterium bovis in New Zealand red deer (Cervus elaphus) using a composite blood test and antibody assays.

A blood test for tuberculosis in deer was developed as an ancillary test to clarify the status of skin test-positive deer, with non-specific sensitisation following exposure to saprophytic mycobacteria. The blood test incorporates the measurement of the relative humoral and cellular immunological responses to Mycobacterium bovis and M. avium antigens to provide a composite test with high levels of sensitivity (>95%) and specificity (>98%). The specificity of the test has allowed it to be used in parallel with the skin test to salvage thousands of tuberculosis-free deer with non-specific skin test-positive reactions, while its high sensitivity has consistently identified M. bovis-specific reactivity in tuberculous skin test-positive animals. The rules for establishing the diagnostic parameters for the cellular and antibody assays were developed by retrospective analysis of the laboratory results using blood samples from many thousand tuberculous or disease-free deer. The sensitivity of the blood test was tested in this study using 150 animals with tuberculosis diagnosed by the isolation of M. bovis. It had sensitivity values of 95.7-95.9% in herds with a low (<2.0%) or a high (>30.0%) incidence of tuberculosis. The test had a specificity of 98.0% when tested on 218 disease-free animals, 118 of which were skin test-positive. An antibody test was developed to diagnose M. bovis in skin test-negative anergic deer from tuberculosis infected herds. When this test was used with deer blood taken 10 days after reading the skin test, it had a sensitivity of 85.3% for 102 M. bovis-positive deer. When used in combination with skin test, the antibody test complemented the skin test to raise the sensitivity of the combined tests to 95.0%, when antibody-positive or skin test-positive tests were used to diagnose tuberculosis. The specificity of the antibody test was 100% when used to evaluate 218 disease-free deer from non-infected herds.

Journal Article↗
PubMed1987

Dietary restrictions and fecal occult blood testing.

"Unprepped" sigmoidoscopy and fecal occult blood testing were performed simultaneously in 1,000 patients with no dietary restrictions. A total of 102 patients had a positive fecal occult blood test. Of these, 86 had visible blood in the rectum as demonstrated by sigmoidoscopy. Only two of the remaining 16 patients probably had a dietary-induced false-positive result on the occult blood test. Dietary restrictions for guaiac occult blood testing are unnecessary in more than 99 percent of patients.

Adolescent↗
PubMedDate not supplied

Relationship between the fecal occult blood test and benign anal disorders.

BACKGROUND/AIMS: The fecal occult blood test is a very useful method for mass screening for colorectal cancer. The possibility of the fecal occult blood test being positive is high even in benign anal disorders, but the relationship between anal disorders and the fecal occult blood test has not been fully studied. METHODOLOGY: During the period from November 1995 to April 1996, we performed both fecal occult blood test and sigmoid colonofiberscopy for 440 patients with anal disorders who visited our hospital for the first time. RESULTS: The positive fecal occult blood test rate was 18.8% (77/409) for those who had only anal disorders and no findings in the colon and rectum. The positive fecal occult blood test rate was significantly high in the cases with polyps (42.3%) and in those with colorectal cancer (60%). CONCLUSIONS: These findings suggested the need to analyze fecal occult blood test, keeping in mind that fecal occult blood test might be positive even without any malignant findings in the large intestine in about 20% of cases of patients have anal disorders when fecal occult blood test is performed.

Anus Diseases↗
PubMed1988

A stool collection device: the first step in occult blood testing.

Despite widespread fecal blood testing, the technique of gathering stool for sampling has remained uncontrolled. We sought to describe how patients have contended with this awkward step, to study artifact caused by toilet water, and to construct a collection device that prevents sampling problems. A survey of 250 patients showed that most (56%) had retrieved stools from the toilet basin, 17% used a pan or other household receptacle, 10% used newspaper or tissue paper, and 17% had been unable or unwilling. Sampling stool from the toilet basin introduces error because 4% to 75% of blood leaches from the fecal surface into surrounding water after only 4 to 12 minutes, and many toilet sanitizers cause false-positive guaiac reactions. We describe an inexpensive, disposable stool collector; outpatient compliance has been 97% using this device. To avoid biochemical artifact and facilitate stool sampling, we advocate that a collection device be incorporated into the occult blood testing process.

Adult↗