© 2005 Oxford University Press
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In Brief
Study Finds Office-Based FOBT Inadequate for Detecting Colorectal Cancer
A new study has found that an office-based fecal occult blood test (FOBT) that uses a single sample detects less than 5% of advanced colorectal neoplasia.
Randomized controlled trials that have examined FOBT have been based on a test that uses six samples collected by the patient over 3 consecutive days. However, the accuracy of using the single-sample FOBT has not been adequately examined.
In the January 18 issue of the Annals of Internal Medicine, researchers report the results of a prospective cohort study in which 2,665 mostly male patients were given the six-sample at-home FOBT, the office-based FOBT, and a colonoscopy.
Both types of FOBT had high probabilities of true-negative results (93.9% for the at-home FOBT and 97.5% for the office-based FOBT). However, the at-home FOBT had a much higher probability of true-positive results, 23.9% compared with 4.9% for the office-based FOBT. Because the office-based FOBT did not detect 95% of the colorectal neoplasias, the authors recommend that patients who receive a negative result after such a test be offered the six-sample at-home FOBT or another type of colorectal cancer screening.
Clinical Trial Participants Fare No Better or Worse Than Other Patients, Review Finds
Patients who participate in randomized controlled trials do not have better or worse outcomes than other patients, according to a new review.
The review from the Cochrane Collaboration, which was published in the January issue of The Cochrane Library, examined the results of five randomized studies and 50 non-randomized cohort studies. In most of the studies, there was no difference in outcomes between participants in randomized controlled trials and other patients. Ten comparisons found that trial participants fared better than other patients, and four comparisons found that trial participants had worse outcomes.
"In addition to being informed about the risks and harms of specific clinical interventions,...patients can be told that this review suggests that, independently of the effects of the clinical interventions being compared, participating in a trial is likely to result in similar outcomes as if they receive similar treatment outside the trial," the review's authors concluded.
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