Value of retesting subjects with a positive Hemoccult in screening for colorectal cancer. 1990

J Kewenter, and B Engarås, and E Haglind, and J Jensen
Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.

Within a prospective randomized screening study for early detection of colorectal cancer with rehydrated Hemoccult II test, the possibility of increasing the specificity of the test by retesting patients with an initially positive Hemoccult II test was investigated. Of those offered the test 3561 (62.6 per cent) returned it and it was positive in 210 cases (5.9 per cent). The repeat test was performed by 184 patients and was positive in 68 (1.9 per cent). All those with a positive initial test had rectosigmoidoscopy to 60 cm and a double contrast enema. A carcinoma was found in one in seven patients with a positive retest but in only one in 100 patients with a negative retest (P less than 0.001). The specificity of the test was, therefore, increased from 95 per cent to 98 per cent and the sensitivity was unchanged. Rescreening was offered at a later date and increased numbers were available: 7147 patients returned the test and 369 (5.2 per cent) were positive. The test was repeated in 360 patients and 118 (1.7 per cent) were positive. A colorectal neoplasm was found in one in three of those with a positive repeat test, compared with one in seven of those with a negative repeat test. In conclusion, screening for early detection of colorectal cancer with a rehydrated Hemoccult II test may be followed by investigation of only those patients with a positive retest. Such a procedure will reduce the work-load by 60 per cent without reducing sensitivity.

UI MeSH Term Description Entries
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D009780 Occult Blood Chemical, spectroscopic, or microscopic detection of extremely small amounts of blood. Fecal Occult Blood Test,Blood, Occult
D011336 Probability The study of chance processes or the relative frequency characterizing a chance process. Probabilities
D011933 Reagent Kits, Diagnostic Commercially prepared reagent sets, with accessory devices, containing all of the major components and literature necessary to perform one or more designated diagnostic tests or procedures. They may be for laboratory or personal use. Diagnostic Reagent Kits,Diagnostic Reagents and Test Kits,Diagnostic Test Kits,In Vitro Diagnostic Device,In Vitro Diagnostic Devices,In Vitro Diagnostic Medical Device,In Vitro Diagnostic Medical Devices,Kits, Diagnostic Reagent,Diagnostic Reagent Kit,Diagnostic Test Kit,Kit, Diagnostic Reagent,Kit, Diagnostic Test,Kits, Diagnostic Test,Reagent Kit, Diagnostic,Test Kit, Diagnostic,Test Kits, Diagnostic
D004733 Enema Insertion of a solution or compound through the RECTUM with the purpose of cleansing the COLON or for diagnostic procedures. Enemata,Enemas,Enematas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001466 Barium Sulfate A compound used as an x-ray contrast medium that occurs in nature as the mineral barite. It is also used in various manufacturing applications and mixed into heavy concrete to serve as a radiation shield. Barite,Baritop,Barium Sulfate (2:1),E-Z-CAT,Micropaque Oral,E Z CAT,EZCAT,Sulfate, Barium
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D012812 Sigmoidoscopy Endoscopic examination, therapy or surgery of the sigmoid flexure. Proctosigmoidoscopy,Sigmoidoscopic Surgical Procedures,Surgical Procedures, Sigmoidoscopic,Sigmoidoscopic Surgery,Surgery, Sigmoidoscopic,Procedure, Sigmoidoscopic Surgical,Procedures, Sigmoidoscopic Surgical,Proctosigmoidoscopies,Sigmoidoscopic Surgeries,Sigmoidoscopic Surgical Procedure,Sigmoidoscopies,Surgeries, Sigmoidoscopic,Surgical Procedure, Sigmoidoscopic
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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