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Kaiser Permanente Study Shows Under Used Colon Cancer Screening Test Is Effective
An under used colon cancer
screening test now available in the U.S. effectively detects colorectal
cancer and may help to improve colon cancer screening rates, according to
investigators at the Kaiser Permanente Division of Research. The study
appears in the September 25, 2007 issue of the Journal of the National
Cancer Institute (JNCI).
Improved Fecal Occult Blood Tests (FOBT) called Fecal Immunochemical
Tests (FITs), look for human blood in the stool and are more effective at
detecting cancers and polyps than the older and more widely used stool
screening tests -- the guaiac tests (GTs), said James Allison, MD, an
adjunct investigator with the Kaiser Permanente Division of Research, UCSF
Clinical Professor of Medicine Emeritus and lead author of the study.
Investigators and gastroenterologist clinicians at Kaiser Permanente's
Northern California Division of Research compared the performance of FIT
and a sensitive GT in 5,841 people with an average risk for colorectal
cancer and looked at the tests' ability to detect colorectal cancers and
polyps in people with the disease (sensitivity) and the tests' ability to
determine which people do not have the disease (specificity).
The FIT had a sensitivity of 81.8% for detecting colorectal cancers and
a specificity of 96.9%. The GT was 64.3% sensitive for detecting colorectal
cancers and 90.1% specific. The higher specificity of the FIT means that
there are fewer false positive results and, therefore, fewer interventional
procedures need to be performed in patients without disease, said the
researchers.
"FIT is an important and a welcome addition to our screening tool kit,
especially because according to the National Cancer Institute, colorectal
cancer screening rates continue to lag well behind those for other cancers.
All recommended screening tests are effective tools for detecting
colorectal cancer early, when it is highly curable," said Allison. "No
screening test is perfect, but any is better than none, and ultimately, the
best screening test is the one the patient actually completes." FIT is
convenient for patients because it is easy to prepare and complete at home
and does not involve dietary restriction, explained the researchers.
FIT is more specific than the sensitive GT for detecting cancers and
polyps because it detects human blood in the stool. The GT, on the other
hand, detects peroxidase activity found in both human and non-human blood
as well as in many vegetables such as broccoli and horseradish. This can
lead to more false positives, explained the researchers.
FIT has other advantages as well, according to the researchers. Some
FITs can be developed and interpreted by lab equipment. This innovation
allows for management of large numbers of tests in a standardized manner
with excellent quality assurance, they explained.
The study was funded by the National Cancer Institute, American
Digestive Health Foundation Outcomes Research Training Award, Kaiser
Foundation Health Plan Community Benefit Program, The Permanente Medical
Group Innovation Program; Beckman Coulter, Inc., and Enterix Corporation.
Additional authors on this study include Theodore R Levin, Jo P.
Tucker, Irene S. Tekawa, Wei K. Zhao, and Joseph Selby all from the Kaiser
Permanente Division of Research in Oakland, Ca; Albert M. Palitz, from the
department of gastroenterology, Kaiser Permanente Medical Center in Walnut
Creek; Lori C. Sakoda, department of epidemiology, School of Public Health
and Community Medicine, University of Washington, Seattle; Thomas Cuff,
department of medicine, Kaiser Permanente Medical Center in Richmond, CA;
Mary Pat Pauley, department of medicine Kaiser Permanente Medical Center,
Sacramento; Lyle Shlager, department of internal medicine Kaiser Permanente
Medical Center, San Francisco; J. Sanford Schwartz, department of medicine,
University of Pennsylvania; David F. Ransohoff, departments of medicine and
epidemiology, University of North Carolina at Chapel Hill.
About Kaiser Permanente
The Kaiser Permanente Division of Research conducts, publishes, and
disseminates epidemiologic and health services research to improve the
health and medical care of Kaiser Permanente members and the society at
large. It seeks to understand the determinants of illness and well-being
and to improve the quality and cost-effectiveness of health care.
Currently, DOR's 400-plus staff is working on more than 250 epidemiological
and health services research projects.
Kaiser Permanente is America's leading integrated health plan. Founded
in 1945, it is a not-for-profit; group practice prepayment program
headquartered in Oakland, Calif. Kaiser Permanente serves the health care
needs of more than 8.7 million members in nine states and the District of
Columbia. Today it encompasses the not-for-profit Kaiser Foundation Health
Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the
for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente
includes approximately 156,000 technical, administrative and clerical
employees and caregivers, and more than 13,000 physicians representing all
specialties.
Kaiser Permanente
http://www.kaiserpermanente.org
Kaiser permanente studiul aratã Sub folosita Colon Cancer test screening este eficace - Kaiser Permanente Study Shows Under Used Colon Cancer Screening Test Is Effective - articole medicale engleza - startsanatate