Fecal occult blood testing in colorectal cancer screening programs

Colorectal carcinoma (CRC) is the third most common cancer worldwide and ranks second as a cause of cancer mortality. CRC screening is carried out in many countries for detection early-stage CRC and its prevention by removing precancerous lesions, and includes fecal occult blood testing and colonosc...

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Main Authors: N. V. Severskaya, A. A. Nevolskikh, V. A. Avdeenko, Zh. V. Hailova, S. A. Ivanov
Format: Article
Language:Russian
Published: QUASAR, LLC 2022-09-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/831
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author N. V. Severskaya
A. A. Nevolskikh
V. A. Avdeenko
Zh. V. Hailova
S. A. Ivanov
author_facet N. V. Severskaya
A. A. Nevolskikh
V. A. Avdeenko
Zh. V. Hailova
S. A. Ivanov
author_sort N. V. Severskaya
collection DOAJ
description Colorectal carcinoma (CRC) is the third most common cancer worldwide and ranks second as a cause of cancer mortality. CRC screening is carried out in many countries for detection early-stage CRC and its prevention by removing precancerous lesions, and includes fecal occult blood testing and colonoscopy. Different countries use their own approach to screening, including methods of detection of fecal occult blood. The strategy for fecal occult blood testing is based on the fact that already in the early stages the tumor can bleed, and small traces of blood in the stool are detected before the onset of clinical symptoms of the disease. Different countries use their own approach to the CRC screening, including methods for fecal occult blood testing. Chemical and immunochemical methods are used to determine occult blood in the feces. The chemical method is based on the detection of heme peroxidase activity. The immunochemical method detects human globin using specific antibodies. The immunochemical method can be qualitative and quantitative. The sensitivity of a quantitative immunochemical test depends on the selected threshold and the stage of CRC. The lower the threshold value, the higher the sensitivity, but the lower the specificity due to false positive results. CRC screening programs use different thresholds for quantitative immunochemical testing in different countries, which is caused by the availability of colonoscopy in a positive test result, as well as the rate of CRC in this population. To increase the sensitivity of the immunochemical test, some programs suggest using it in combination with other methods: detection of DNA in stool, examination of other proteins in feces (transferrin, haptoglobin). This review presents the methods used in the world for fecal occult blood testing, their advantages and limitations; recommendations for reporting the results of a quantitative immunochemical test; thresholds recommended in screening programs in different countries for quantitative immunochemical tests. The results of pilot screening for fecal occult blood testing in some regions of the Russian Federation are also presented.
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spelling doaj-art-a0e176e5ba45468dbf27313bd06feb752025-08-20T04:00:14ZrusQUASAR, LLCИсследования и практика в медицине2410-18932022-09-019314515910.17709/2410-1893-2022-9-3-11463Fecal occult blood testing in colorectal cancer screening programsN. V. Severskaya0A. A. Nevolskikh1V. A. Avdeenko2Zh. V. Hailova3S. A. Ivanov4National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationA. F. Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological Center; IATE MEPHIIATE MEPHIA. F. Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological CenterA. F. Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological Center; Peoples Friendship University of Russia; National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationColorectal carcinoma (CRC) is the third most common cancer worldwide and ranks second as a cause of cancer mortality. CRC screening is carried out in many countries for detection early-stage CRC and its prevention by removing precancerous lesions, and includes fecal occult blood testing and colonoscopy. Different countries use their own approach to screening, including methods of detection of fecal occult blood. The strategy for fecal occult blood testing is based on the fact that already in the early stages the tumor can bleed, and small traces of blood in the stool are detected before the onset of clinical symptoms of the disease. Different countries use their own approach to the CRC screening, including methods for fecal occult blood testing. Chemical and immunochemical methods are used to determine occult blood in the feces. The chemical method is based on the detection of heme peroxidase activity. The immunochemical method detects human globin using specific antibodies. The immunochemical method can be qualitative and quantitative. The sensitivity of a quantitative immunochemical test depends on the selected threshold and the stage of CRC. The lower the threshold value, the higher the sensitivity, but the lower the specificity due to false positive results. CRC screening programs use different thresholds for quantitative immunochemical testing in different countries, which is caused by the availability of colonoscopy in a positive test result, as well as the rate of CRC in this population. To increase the sensitivity of the immunochemical test, some programs suggest using it in combination with other methods: detection of DNA in stool, examination of other proteins in feces (transferrin, haptoglobin). This review presents the methods used in the world for fecal occult blood testing, their advantages and limitations; recommendations for reporting the results of a quantitative immunochemical test; thresholds recommended in screening programs in different countries for quantitative immunochemical tests. The results of pilot screening for fecal occult blood testing in some regions of the Russian Federation are also presented.https://www.rpmj.ru/rpmj/article/view/831colorectal cancerscreeningfecal occult bloodfecal immunochemical test
spellingShingle N. V. Severskaya
A. A. Nevolskikh
V. A. Avdeenko
Zh. V. Hailova
S. A. Ivanov
Fecal occult blood testing in colorectal cancer screening programs
Исследования и практика в медицине
colorectal cancer
screening
fecal occult blood
fecal immunochemical test
title Fecal occult blood testing in colorectal cancer screening programs
title_full Fecal occult blood testing in colorectal cancer screening programs
title_fullStr Fecal occult blood testing in colorectal cancer screening programs
title_full_unstemmed Fecal occult blood testing in colorectal cancer screening programs
title_short Fecal occult blood testing in colorectal cancer screening programs
title_sort fecal occult blood testing in colorectal cancer screening programs
topic colorectal cancer
screening
fecal occult blood
fecal immunochemical test
url https://www.rpmj.ru/rpmj/article/view/831
work_keys_str_mv AT nvseverskaya fecaloccultbloodtestingincolorectalcancerscreeningprograms
AT aanevolskikh fecaloccultbloodtestingincolorectalcancerscreeningprograms
AT vaavdeenko fecaloccultbloodtestingincolorectalcancerscreeningprograms
AT zhvhailova fecaloccultbloodtestingincolorectalcancerscreeningprograms
AT saivanov fecaloccultbloodtestingincolorectalcancerscreeningprograms