A study of disease probability according to the number of clinical predictors in those testing positive in colon cancer screening

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  • 大腸がん検診陽性者における臨床予測因子保有数別疾患確率の検討
  • ダイチョウ ガン ケンシン ヨウセイシャ ニ オケル リンショウ ヨソク インシ ホユウスウ ベツ シッカン カクリツ ノ ケントウ

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Abstract

A quantitative immunochemical fecal occult blood test used for colon cancer screening aims to estimate the probability of colon cancer, and increase clinical confidence in the diagnosis. This study prepared a brief clinical prediction model to estimate an individual’s post-test probability of disease for those who tested positive in colon cancer screening conducted in Fukuoka City using a screening form for medical examinees and the quantitative fecal hemoglobin (Hb) concentration, and objectively identified that an increasing number of clinical predictors elevates the disease probability of colon cancer. Using the positive fecal occult blood test (two-day method) results at a concentration of >= 500 ng/ml for both days, no past medical examinations, the highest quantitative fecal Hb concentration of >= 1,000 ng/ml, blood feces, and >= 60 years old as clinical indicators, the probability of the disease was increased about 10-fold compared to a positive predictive value of 5.9%. The marked level of clinical confidence is expected to promote physicians’ activities to recommend and help motivate examinees to undergo a complete examination.

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