Author/Authors :
Mousavinezhad, Maryam School of Public Health - Tehran University of Medical Sciences, Tehran, Iran , Majdzadeh, Reza School of Public Health and Knowledge Utilization Research Center - Tehran University of Medical Sciences, Tehran, Iran , Akbari Sari, Ali School of Public Health - Tehran University of Medical Sciences, Tehran, Iran , Delavari, Alireza Digestive Disease Research Center - Tehran University of Medical Sciences, Tehran, Iran , Mohtasham, Farideh Knowledge Utilization Research Centre (KURC) - Tehran University of Medical Sciences, Tehran, Iran
Abstract :
Background: After lung and prostate cancers, colorectal cancer (CRC) is the third most common cancer in
men and the second most common cancer in women after breast cancer worldwide. Every year, more than one
million people are diagnosed with colorectal cancer worldwide and half of these patients die from this disease,
making it the fourth leading cause of death in the world. This systematic review aimed to assess the effectiveness
of the two colorectal diagnostic tests of FOBT (fecal occult blood test) and FIT (fecal immunochemical
test)) in terms of technical performance.
Methods: To retrieve the relevant evidence, appropriate medical databases such as Cochrane library,
NHSEED, Scopus and Google scholar were searched from February 2013 to July 2014, using free-texts and
Mesh. In this study, inclusion/exclusion criteria of the papers, randomized controlled trials, economic evaluations,
systematic reviews, meta-analyses and meta-syntheses of the effectiveness of FIT versus FOBT tests in
moderate-risk populations (age: 50 to 70 years), which had reported the least of such outcomes as sensitivity,
specificity and clinical outcomes were reviewed. The analyses of the effectiveness outcomes were performed in
the form of meta-analysis.
Results: Five papers were eligible to be included in the final phase of the study for synthesis. FIT showed a
better performance in participation and positivity rate. Moreover, in terms of false positive and negative rate,
FIT showed fewer rates compared to FOBT (RR:-4.06; 95% CI (-7.89-0.24), and NN-scope (Number need to
scope) (2.2% vs. 1.6%), and NN-screen (Number need to screen) (84% vs. 31-49% in different cut off levels)
showed significant differences in FOBT vs. FIT, respectively.
Conclusion: In the five included studies (3, 11-14), the acceptability of FIT was more than FOBT. However, in
our meta-analysis, no difference was found between the two tests. FIT was significant in positivity rate and had
a better performance in participation rate, and a fewer false negative numbers compared to FOBT.
