Articles: guaiac.
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To assess the feasibility, participation and neoplasia yield of adding a flexible sigmoidoscopy (FS) once in a lifetime to a colorectal cancer screening programme with guaiac-based faecal occult blood test (gFOBT). ⋯ A population-based screening programme with the addition of FS to gFOBT is feasible and safe through an organisation involving GPs. The performances of the two screening tools are complementary: high compliance - low yield for gFOBT and vice versa for FS. The addition of a single FS screening in people aged 55-64 to an organised programme with biennial gFOBT in people aged 50-74 is a colorectal cancer screening option that deserves further exploration.
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J. Clin. Gastroenterol. · Oct 2006
Prospective evaluation of the use and outcome of admission stool guaiac testing: the Digital Rectal Examination on Admission to the Medical Service (DREAMS) Study.
Although physicians often perform fecal occult blood testing at the time of hospital admission, the practice of admission stool guaiac (ASG) testing has not been evaluated prospectively. The aim of this study was to determine the frequency and outcomes of digital rectal examination (DRE) and ASG testing in patients admitted to the hospital. ⋯ Although DRE and ASG testing are commonly performed on admission to the hospital, documentation of the findings and follow-up of positive tests are poor. These findings highlight the need to improve physician training on the appropriate use and documentation of the DRE and fecal occult blood testing.
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Aliment. Pharmacol. Ther. · Jan 2006
Multicenter StudyComparative evaluation of a new bedside faecal occult blood test in a prospective multicentre study.
Faecal occult blood testing is an established method of colorectal neoplasia screening. Guaiac-based tests are limited by poor patient compliance, low sensitivity, specificity and positive predictive value. Newer immunochemical-based tests, accurate but tedious, require a well-established laboratory set up. There is need for simpler immunochemical tests that can be performed at the out-patient clinic. ⋯ This bedside immunochemical strip test proved to be a simple, convenient, non-cumbersome and accurate tool with similar performance characteristics for detection of any bleeding lesion including colorectal neoplasia when compared with an established immunochemical faecal occult blood test.
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Comparative Study
Fecal occult blood testing in a general medical clinic: comparison between guaiac-based and immunochemical-based tests.
Guaiac-based fecal occult blood tests are limited by poor patient compliance, and low sensitivity, specificity, and positive predictive value. Newer immunochemical-based tests are designed to improve accuracy and patient compliance. We compared patient compliance and the test characteristics of these two types of tests. ⋯ Overall, immunochemical-based and guaiac-based fecal occult blood tests had comparable performance. However, although immunochemical-based testing is reported to be easier for patients than guaiac-based testing, we found that patients were no more likely to return cards for analysis. The similar positive predictive value and additional cost of immunochemical-based tests call into question their utility in general practice.
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Microscopic stool examination can distinguish inflammatory from noninflammatory diarrheas. The modified guaiac test was shown to have good correlation to stool microscopy. In a prospective study we evaluated the diagnostic accuracy of a modified guaiac test (Colo-Rectal-Test, Roche) and of an immunological test for fecal haemoglobin (Colo-Immun-Test, Roche) in relation to the diarrheal pathogens identified and compared it with the stool microscopy. ⋯ A modified guaiac test can replace microscopic stool examination to distinguish between inflammatory and non-inflammatory diarrhea. Immunological testing for occult blood can improve the specificity of the guaiac test, but is too elaborate to serve as a screening test. The modified guaiac test can easily be handled by community health workers and could be important in the diagnostic work-up for acute infectious diarrhea.