Aspirin and immunochemical fecal occult blood testing

January 01, 0001

Aspirin and immunochemical fecal occult blood testing

Immunochemical fecal occult blood tests (iFOBTs) are a newer form of non-invasive colorectal cancer screening. These German researchers sought to assess affects of low-dose aspirin use on the performance of 2 quantitative iFOBTs. They did so with a diagnostic study at primary care and gastrointestinal practices in Germany (n=1979 patients, 233 aspirin users and 1746 non-users.

The researchers report: "Advanced neoplasms were found in 24 users (10.3%) and 181 nonusers (10.4%) of low-dose aspirin. At the cut point recommended by the manufacturer, sensitivities of the 2 tests were 70.8% for users compared with 35.9% for nonusers and 58.3% for users compared with 32.0% for nonusers. Specificities were 85.7% for users compared with 89.2% for nonusers and 85.7% for users compared with 91.1% for nonusers. The areas under the ROC curve were 0.79 for users compared with 0.67 for nonusers and 0.73 for users compared with 0.65 for nonusers. Among men, who composed the majority of low-dose aspirin users, the areas under the ROC curve were 0.87 for users compared with 0.68 for nonusers and 0.81 for users compared with 0.67 for nonusers."

The researchers concluded: "For 2 iFOBTs, use of low-dose aspirin compared with no aspirin was associated with a markedly higher sensitivity for detecting advanced colorectal neoplasms, with only a slightly lower specificity."

Low dose aspirin use improves the sensitivity of iFOBTs in screening for colon cancer

For the full abstract, click here.

JAMA 304(22:2513-2520, 8 December 2010
© 2010 American Medical Association.
Low-Dose Aspirin Use and Performance of Immunochemical Fecal Occult Blood Tests. Hermann Brenner, Sha Tao, Ulrike Haug.

Category: D. Digestive. Keywords: immunological fecal occult blood testing, iFOBT, colon cancer, aspirin, screening, diagnostic study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 17 December 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.