Sensitivity of Two-Time Immunochemical Fecal Occult-Blood Testing with Sigmoidoscopy for the Detection of Advanced Colon Adenoma

Korean J Gastrointest Endosc > Volume 28(6); 2004 > Article

Korean Journal of Gastrointestinal Endoscopy 2004;28(6): 291-297.

진행성 대장 선종에서 S상결장내시경과 2회 면역화학 대변잠혈반응검사의 진단 민감도

석기태·김현수·김정권·김정민·지명관·지상원·백순구·이동기·권상옥

연세대학교 원주의과대학 내과학교실

Sensitivity of Two-Time Immunochemical Fecal Occult-Blood Testing with Sigmoidoscopy for the Detection of Advanced Colon Adenoma

Ki Tae Suk, M.D., Hyun Soo Kim, M.D., Jung Kwon Kim, M.D., Jung Min Kim, M.D., Myeong Gwan Jee, M.D., Sang Won Ji, M.D., Soon Koo Baik, M.D.,Dong Ki Lee, M.D. and Sang Ok Kwon, M.D.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Abstract

Background/Aims:
Because detection and removal of colonic adenoma provided an opportunity to prevent colorectal cancer, advanced adenoma (＞10 mm, villous or high grade dysplasia) should be the major target of screening. In this study, we assessed the diagnostic sensitivity of one- or two-time immunochemical fecal occult blood test (i-FOBT), flexible sigmoidoscopy and their combination in patients with advanced adenoma or non-advanced adenoma.
Methods:
From January to October 2002, we performed colonoscopy with i-FOBT using latex agglutination method in 879 individuals. Among these, we diagnosed 234 polyps in 93 patients with advanced adenoma and 179 polyps in 109 patients with non-advanced adenoma. After the diagnosis of adenoma, second i-FOBT was done before polypectomy. Based on these data, we evaluated the diagnostic sensitivities of i-FOBT, flexible sigmoidoscopy and their combination for patients with advanced adenoma or non-advanced adenoma.
Results:
The diagnostic sensitivity of one- or two-time i-FOBT, flexible sigmoidoscopy and flexible sigmoidoscopy with two-time i-FOBT in patients with advanced adenoma vs.non-advanced adenoma were 17.2% vs. 18.3%, 28.0% vs. 29.4%, 70.1% vs. 66.1% and 81.7% vs. 78.0%. Although repeated application of i-FOBT enhanced diagnostic sensitivity for colon adenoma, this test or combination with flexible sigmoidoscopy did not differentiate advanced adenoma from non-advanced adenoma.
Conclusions:
Although it fails to detect one fifth of colon adenoma, combined two-time i-FOBT testing with flexible sigmoidoscopy is an effective and feasible screening modality for advanced colon adenoma. (Korean J Gastrointest Endosc 2004;28:291⁣297)

Key Words: Advanced colon adenoma, Sigmoidoscopy, Fecal occult blood test, Screening

주요어: 진행성 대장 선종, S상결장내시경검사, 대변잠혈반응검사, 선별검사