Immunochemical faecal occult blood tests in primary care and the risk of delay in the diagnosis of colorectal cancer
2013 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 31, no 4, 209-214 p.Article in journal (Refereed) Published
Objective. To evaluate the value, risks, and shortcomings of immunochemical faecal occult blood tests (iFOBTs) in the diagnosis of colorectal cancer (CRC) and adenomas with high-grade dysplasia (HGD) in patients initially presenting to primary care. Design. A retrospective population-based study. Setting and subjects. All 495 cases of CRC and adenomas with HGD diagnosed in the county of Jamtland, Sweden from 2005 to 2009. Results. Of 495 patients 323 (65%) initially presented to primary care. IFOBTs were performed in 215 of 323 (67%) patients. The sensitivity of iFOBT for CRC and adenomas with HGD was 88% (83% when patients with a history of rectal bleeding were excluded). Of 34 patients with anaemia found en passant, 10 had negative iFOBTs. Time to diagnosis was longer for patients with negative iFOBTs (p < 0.0005). Conclusion. IFOBT might be helpful in selecting which patients to refer for colonoscopy. However, iFOBT has a limited sensitivity as a diagnostic test for CRC and adenomas with HGD. Relying only on iFOBT for colonoscopy referral could delay diagnosis, especially for patients with anaemia found en passant.
Place, publisher, year, edition, pages
Informa Healthcare, 2013. Vol. 31, no 4, 209-214 p.
Colorectal neoplasms, diagnosis, general practice, occult blood, signs and symptoms
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology
IdentifiersURN: urn:nbn:se:umu:diva-83695DOI: 10.3109/02813432.2013.850205OAI: oai:DiVA.org:umu-83695DiVA: diva2:675775