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Abstract：
BACKGROUND: The predictive value of immunological fecal occult blood (iFOB) testing for the screening of colorectal cancer has been well described in the Western world. However, its relevance in Sub-Saharan Africa (SSA) is not well evaluated. It could be altered by the other causes of lower gastrointestinal bleeding such as parasitic infections. The aim of this study was to highlight the performance of an iFOB test for the prediction of colorectal cancer (CRC) during colonoscopy in SSA.
METHODS: We conducted an analytical cross-sectional study in two digestive endoscopic centers of Yaoundé (Cameroon) from the 1st July to the 31 November 2022. Patients presenting with an indication for colonoscopy without any overt gastrointestinal bleeding were included. Sociodemographic and clinical data were collected. All consenting patients underwent a qualitative immunologic occult test through the iFOB test before colonoscopy. Data were analyzed using SPSS version 23.0 software. The performance of the iFOB test for the diagnosis of CRC during colonoscopy was evaluated in terms of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).
RESULTS: We included 103 patients during the study period with a male predominance and a sex ratio of 1.7. The median age [IQR] was 52 [38-65] years (range 1 - 84 years). The most common colonoscopic lesions were polyps in 23 patients (22.3%), CRC in 17 patients (16.5%) and hemorrhoids in 15 patients (14.6%). Patients testing positive for iFOB test accounted for 43.7% (45 patients). Among these patients, 31.1% (14 patients) had a CRC. The Se of the occult blood test for CRC detection was calculated to be 82.3% (95%CI: 56.7-96.2); the Sp was 63.9% (95% CI: 53-74); the PPV was 31.1% (95% CI: 24-39) and the NPV was 94.8% (95% CI: 86.6-98.1).
CONCLUSIONS: The iFOB test has a good NPV, but a poor PPV for the diagnosis of CRC in our study.
METHODS: We conducted an analytical cross-sectional study in two digestive endoscopic centers of Yaoundé (Cameroon) from the 1st July to the 31 November 2022. Patients presenting with an indication for colonoscopy without any overt gastrointestinal bleeding were included. Sociodemographic and clinical data were collected. All consenting patients underwent a qualitative immunologic occult test through the iFOB test before colonoscopy. Data were analyzed using SPSS version 23.0 software. The performance of the iFOB test for the diagnosis of CRC during colonoscopy was evaluated in terms of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).
RESULTS: We included 103 patients during the study period with a male predominance and a sex ratio of 1.7. The median age [IQR] was 52 [38-65] years (range 1 - 84 years). The most common colonoscopic lesions were polyps in 23 patients (22.3%), CRC in 17 patients (16.5%) and hemorrhoids in 15 patients (14.6%). Patients testing positive for iFOB test accounted for 43.7% (45 patients). Among these patients, 31.1% (14 patients) had a CRC. The Se of the occult blood test for CRC detection was calculated to be 82.3% (95%CI: 56.7-96.2); the Sp was 63.9% (95% CI: 53-74); the PPV was 31.1% (95% CI: 24-39) and the NPV was 94.8% (95% CI: 86.6-98.1).
CONCLUSIONS: The iFOB test has a good NPV, but a poor PPV for the diagnosis of CRC in our study.
摘要：
背景：在西方世界已经很好地描述了免疫粪便隐血（iFOB）检测对结直肠癌筛查的预测价值。然而,它在撒哈拉以南非洲(SSA)的相关性没有得到很好的评估。它可能被下消化道出血的其他原因改变，如寄生虫感染。这项研究的目的是强调iFOB测试在SSA结肠镜检查期间预测结直肠癌（CRC）的性能。
方法：我们于2022年7月1日至11月31日在雅温得（喀麦隆）的两个消化内镜中心进行了分析性横断面研究。包括具有结肠镜检查指征而没有任何明显胃肠道出血的患者。收集社会人口统计学和临床数据。所有同意的患者在结肠镜检查前通过iFOB测试进行了定性免疫隐匿性测试。数据采用SPSS23.0版软件进行分析。根据敏感性（Se）评估了在结肠镜检查期间诊断CRC的iFOB测试的性能，特异性（Sp），阳性预测值(PPV)和阴性预测值(NPV)。
结果：我们在研究期间纳入了103名男性占优势且性别比为1.7的患者。中位年龄[IQR]为52[38-65]岁（范围1-84岁）。结肠镜检查最常见的病变是23例（22.3%）息肉，CRC患者17例（16.5%），痔疮患者15例（14.6%）。iFOB检测阳性的患者占43.7％（45名患者）。在这些患者中,31.1％（14例）患有CRC。用于CRC检测的隐血测试的Se计算为82.3％（95CI：56.7-96.2）；Sp为63.9％（95％CI：53-74）；PPV为31.1％（95％CI：24-39），NPV为94.8％（95％CI：86.6-98.1）。
结论：iFOB测试具有良好的净现值，但在我们的研究中，用于诊断CRC的PPV较差。
方法：我们于2022年7月1日至11月31日在雅温得（喀麦隆）的两个消化内镜中心进行了分析性横断面研究。包括具有结肠镜检查指征而没有任何明显胃肠道出血的患者。收集社会人口统计学和临床数据。所有同意的患者在结肠镜检查前通过iFOB测试进行了定性免疫隐匿性测试。数据采用SPSS23.0版软件进行分析。根据敏感性（Se）评估了在结肠镜检查期间诊断CRC的iFOB测试的性能，特异性（Sp），阳性预测值(PPV)和阴性预测值(NPV)。
结果：我们在研究期间纳入了103名男性占优势且性别比为1.7的患者。中位年龄[IQR]为52[38-65]岁（范围1-84岁）。结肠镜检查最常见的病变是23例（22.3%）息肉，CRC患者17例（16.5%），痔疮患者15例（14.6%）。iFOB检测阳性的患者占43.7％（45名患者）。在这些患者中,31.1％（14例）患有CRC。用于CRC检测的隐血测试的Se计算为82.3％（95CI：56.7-96.2）；Sp为63.9％（95％CI：53-74）；PPV为31.1％（95％CI：24-39），NPV为94.8％（95％CI：86.6-98.1）。
结论：iFOB测试具有良好的净现值，但在我们的研究中，用于诊断CRC的PPV较差。
