Korean J Fam Pract. 2016; 6(5): 435-440  https://doi.org/10.21215/kjfp.2016.6.5.435
Fecal Occult Blood Test as a Screening Method for Asymptomatic Patients with Colorectal Neoplasia
Kyung-Koo Han1, Chang-Ho Youn1,*, Hae-Jin Ko1, A-Sol Kim1, Hyo-Min Kim2, Hyun-Sook Kim2, Sung-Kyu Park1
1Department of Family Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine;
2Department of Family Medicine, Kyungpook National University Medical Center, Daegu, Korea
Chang-Ho Youn
Tel: +82-53-200-5791, Fax: +82-53-200-5480
E-mail: ychfm@knu.ac.kr
Received: March 30, 2016; Revised: May 23, 2016; Accepted: June 1, 2016; Published online: October 20, 2016.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Colorectal cancer is one of the most common malignant tumors, and its occurrence has been increasing recently. The fecal occult blood test (FOBT) has been studied for its usefulness as a screening method of colorectal cancer. However, in Korea, adequate studies on colorectal neoplasia, including premalignant polyps, are lacking. Thus, this study focused on the usefulness of FOBT as a screening method for colorectal neoplasia.

Methods: A total of 32,813 asymptomatic adults who visited a general hospital for health screenings from 2005 to 2010 were included in the analysis. Of these, 2,991 subjects underwent both FOBT and screening colonofiberscopy (CFS). According to the CFS result, the subjects were divided into four groups: normal, tubular adenoma, advanced adenoma, and cancer. The usefulness of FOBT compared to CFS was analyzed.

Results: The rate of diagnosed colorectal cancer from positive FOBT cases was 7.9%, and this was a statistically meaningful and higher result compared to the rate of 0.6% from negative FOBT cases. Moreover, FOBT showed 22% sensitivity and 98% specificity. Multivariate logistic regression analyses revealed odds ratios of 0.368 and 6.176 in the tubular adenoma and colorectal cancer groups, respectively.

Conclusion: FOBT is a useful screening method for colorectal cancer, with appropriate sensitivity and specificity. However, it has a low value for precancerous lesions such as adenoma because of its low sensitivity for the diagnosis of all colonic neoplasms.

Keywords: Fecal Occult Blood Test; Colonofiberscopy; Colorectal Cancer; Colorectal Neoplasia
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