engleski

Hemoccult test sensitivity and specificity - Cratian experience

The incidence of colon cancer increased considerably in Croatia in the period 1980-1992 (from 24.1 to 34.5 /100000): the increase in mortality (from 15.5. in 1980 to 22.1 in 1992) and low survival (in the city of Osijek only 32.1 percent of those operated on) indicate that early detection of colorectal carcinom is not sufficiently participated. Wourld experience shows considerable decrease in mortality rate (test sensitivity 60-80 percent). The purpose of this study was to assess the validity, sensitivity and specificity of the hemoccult test. Occult blood testing in the feces was conducted between 1980 and 1984 on a random sample of 11434 patient (9259)in above 40 risk group and 2172 control patients aged 20-40). Occult bleeding was detected in 83 older patients (1.09 percent) and 9 control patients (0.53 prercent). Colonoscopy revealed 13 carcinoma (0.17 percent) in the risk group. High population motivation for early detection and hemoccult test acceptably were found. Costs per patinet detected were by 27.4 percent lower than paliative treatment. The observation of the incidence of colorectal carcinoma in 7509 Hemoccult nagative subjects over an 8-year period revealed colorectal carcinoma in 22 cases (1 in the 1st year ; 4 in the 2nd ; 4 in 3rd ; 4 in 4th ; 4 in 5th ; 2 in 6th ; 1 in 7th and 2 in the 8 th year): Test sensitvity was estimated as 92.8 percent for first year carcinoma incidence, 72.22 percent for second year 59.9 percent for third year 37.1 percent for 8th year carcinoma incidence. Test specificity for the 8 year period was 99.08 percent. Test results point to high Hemoccult sensitivity and specificity when applied every or every second year as the aearly detection method in the asimptomatic population aged over 50. These results confirm to the test effectivness found in other studies. The minimum programm of early detection in Croatia should include minimally high risk groups. The implementation of the program for the over 55 risk group over a 3 year period is feasible in Osijek both technically and personel-wise. This indicates occult blood testing in the feces should be done every second year and sygmoidoscopy every 3-5 years.

Hemoccult test; colorectal cancer

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