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Background Population screening for colorectal cancer (CRC) remains low, requiring alternative approaches for increasing participation. Opportunistic screening of hospitalized patients may aid in increasing uptake rates. Objective To assess whether inpatients can be recruited for opportunistic CRC screening using fecal immunochemical testing (FIT). Methods Inpatient charts were prospectively reviewed for study eligibility on admission of patients to the medical wards of 3 hospitals in Winnipeg, Canada. Eligible patients were approached for participation and consent. Inoculated FIT specimen collection tubes were sent to the hospital laboratory for testing. Patients with positive FIT results received a follow-up colonoscopy. Results In total, 1542 inpatient charts were screened for eligibility; 53 patients were identified for enrollment (51.9% were male; median age, 59 years), of whom 13 patients consented to participate but only 7 provided a stool specimen. One of those 7 patients had a positive FIT result. The overall screening rate was low, at 0.45%. The primary reason for exclusion of patients was age (outside of the range of 50-75 years), followed by patients having recent gastrointestinal bleeding and/or known intestinal diseases. Conclusions Our data suggest that it is infeasible to recruit inpatients for opportunistic CRC screening in routine clinical practice. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine women's attitudes and related factors towards cancer screening in Turkey. Methods: This analytical-cross-sectional study was conducted between June and September 2022. The universe of the study consisted of all women between the ages of 30-70 in Turkey, and the sample included 335 women. The data of the study were collected online with the "Personal Information Form" and "Attitude Scale for Cancer Screening". Results: The average Attitude Scale for Cancer Screening total score of the women participating in the study was 84.36±14.55. Of the women who participated in the study, 33.1% did not perform breast self-examination, 63.1% did not perform clinical breast examination, 49.5% did not perform Pap smear and HPV-DNA testing, 60.9% did not perform mammography, 76.1% did not perform fecal occult blood testing and 93.8% did not perform colonoscopy. It was determined that education status, breast self-examination, clinical breast examination, Pap Smear and HPV-DNA test frequencies, and knowing the places where cancer screening was performed affected the Attitude Scale for Cancer Screening score averages (F = 8.729, p = 0.000). Conclusion: It was determined that the attitudes of the women participating in the study towards cancer screening were moderate. Several factors are done affect attitudes towards cancer screening. [ABSTRACT FROM AUTHOR]

Objective To investigate the independent risk factors among preoperative systemic inflammatory indicators associated with lymph node metastasis (LNM) in patients with colorectal cancer (CRC) and to construct and validate a related risk prediction model. Methods Clinical data of 241 patients with CRC who received surgery at Affiliated Xinhua Hospital of Dalian University from January 2012 to December 2017 were retrospective analyzed. Variable selection was performed using univariate analysis combined with Least Absolute Shrinkage and Selection Operator (LASSO) regression and 10-fold cross-validation. After constructing the best logistic regression model, multivariate analysis was conducted to determine the independent risk factors for preoperative LNM in CRC, and a nomogram was developed. The model was internally validated using the Bootstrap method and its predictive performance and clinical utility were evaluated through receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results Univariate analysis and LASSO regression with cross-validation identified smoking history, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), fibrinogen-to-albumin ratio (FAR), and fecal occult blood (FOB) as variables with non-zero coefficients. Multivariate analysis using these factors showed that smoking history (OR=2.669, 95%CI: 1.158-6.150, P=0.021), high NLR(OR=1.895, 95%CI: 1.379-2.605, P＜0.001), low LMR (OR=0.907, 95%CI: 0.823-0.999, P=0.048), high FAR (OR=1.145, 95%CI: 1.062-1.235, P＜0.001), and positive FOB (OR=2.289, 95%CI: 1.132-4.630, P=0.021) were independent risk factors for LNM in CRC (P＜0.05). The ROC curve, calibration curve, and DCA curve indicated that the nomogram constructed in this study provided benefits to patients. Conclusion The risk predictive model constructed in this study demonstrated good predictive performance and clinical utility for preoperatively identifying LNM in CRC patients.

Background Concerns of gastrointestinal (GI) bleeding after cardiac surgery are increasing with increased use of antiplatelets and anticoagulants. We investigated the roles of preoperative screening for fecal occult blood by fecal immunochemical test (FIT) widely used to detect GI bleeding and cancer. Methods A retrospective review was done in 1,663 consecutive patients undergoing FIT before cardiac surgery between years 2012 and 2020. One or two rounds of FIT were performed 2 to 3 weeks before surgery, when antiplatelets and anticoagulants were not suspended yet. Results Positive FIT (> 30 μg of hemoglobin/g of feces) was observed in 227 patients (13.7%). Preoperative risk factors for positive FIT included age > 70 years, anticoagulants, and chronic kidney disease. Of those with positive FIT, 180 patients (79%) received preoperative endoscopy, including gastroscopy (n = 139), colonoscopy (n = 9), and both (n = 32), with no findings of bleeding. The most common finding of gastroscopy was atrophic gastritis (36%) while early gastric cancer was detected in 2 patients. The most common finding of colonoscopy was colon polyps (42%) while colorectal cancer was detected in 5 patients. Of 180 FIT-positive patients receiving endoscopy, 8 (4.4%) underwent preoperative GI treatment, while postoperative GI events were documented in 28 (15.6%). Of 1,436 with negative FIT, 21 (1.5%) presented GI complications after surgery. Conclusion Preoperative FIT, which is influenced by anticoagulant use, has little impacts on identification of GI bleeding sites. However, it may be useful to detect GI malignant lesions, potentially impacting operative risks, surgical strategies, and postoperative management. [ABSTRACT FROM AUTHOR]

Given the need to improve the sensitivity of non-invasive methods to detect colorectal neoplasia, particularly adenomas, we compared a fecal test using a monoclonal antibody (Mab) raised against constituents of colonic adenomas designated Adnab-9 (Adenoma Antibody 9), recognizing an N-linked 87 kDa glycoprotein, to gFOBT, which is shown to reduce CRC mortality. p87 immunohistochemistry testing is significantly more sensitive (OR 3.64[CI 2.37–5.58]) than gFOBT (guaiac-based fecal occult blood test) for adenomas (<3 in number), advanced adenomas (OR 4.21[CI 2.47–7.15]), or a combination of the two (OR 3.35[CI 2.47–4.53]). p87 immunohistochemistry shows regional Paneth cell (PC) expression mainly in the right-sided colon and is significantly reduced in the ceca of African Americans (p < 0.0001). In a subset of patients, we obtained other body fluids such as urine, colonic effluent, and saliva. Urine tests (organ-specific neoantigen) showed a significant difference for advanced adenomas (p < 0.047). We conclude that fecal p87 testing is more sensitive than gFOBT and Adnab-9 and could be used to better direct the colonoscopy screening effort. [ABSTRACT FROM AUTHOR]

Colorectal carcinoma (CRC) is the third most common cancer worldwide and ranks second as a cause of cancer mortality. CRC screening is carried out in many countries for detection early-stage CRC and its prevention by removing precancerous lesions, and includes fecal occult blood testing and colonoscopy. Different countries use their own approach to screening, including methods of detection of fecal occult blood. The strategy for fecal occult blood testing is based on the fact that already in the early stages the tumor can bleed, and small traces of blood in the stool are detected before the onset of clinical symptoms of the disease. Different countries use their own approach to the CRC screening, including methods for fecal occult blood testing. Chemical and immunochemical methods are used to determine occult blood in the feces. The chemical method is based on the detection of heme peroxidase activity. The immunochemical method detects human globin using specific antibodies. The immunochemical method can be qualitative and quantitative. The sensitivity of a quantitative immunochemical test depends on the selected threshold and the stage of CRC. The lower the threshold value, the higher the sensitivity, but the lower the specificity due to false positive results. CRC screening programs use different thresholds for quantitative immunochemical testing in different countries, which is caused by the availability of colonoscopy in a positive test result, as well as the rate of CRC in this population. To increase the sensitivity of the immunochemical test, some programs suggest using it in combination with other methods: detection of DNA in stool, examination of other proteins in feces (transferrin, haptoglobin). This review presents the methods used in the world for fecal occult blood testing, their advantages and limitations; recommendations for reporting the results of a quantitative immunochemical test; thresholds recommended in screening programs in different countries for quantitative immunochemical tests. The results of pilot screening for fecal occult blood testing in some regions of the Russian Federation are also presented.

Given the need to improve the sensitivity of non-invasive methods to detect colorectal neoplasia, particularly adenomas, we compared a fecal test using a monoclonal antibody (Mab) raised against constituents of colonic adenomas designated Adnab-9 (Adenoma Antibody 9), recognizing an N-linked 87 kDa glycoprotein, to gFOBT, which is shown to reduce CRC mortality. p87 immunohistochemistry testing is significantly more sensitive (OR 3.64[CI 2.37–5.58]) than gFOBT (guaiac-based fecal occult blood test) for adenomas (p < 0.0001). In a subset of patients, we obtained other body fluids such as urine, colonic effluent, and saliva. Urine tests (organ-specific neoantigen) showed a significant difference for advanced adenomas (p < 0.047). We conclude that fecal p87 testing is more sensitive than gFOBT and Adnab-9 and could be used to better direct the colonoscopy screening effort.

Introduction: Fecal occult blood (FOB) test is accepted as an effective screening tool for decreasing colorectal cancer mortality especially after age 50. We aimed to understand its effectiveness among younger age groups, by analyzing the results of control colonoscopy of the patients with FOB test positivity detected during check-up. Methods: Six thousand six hundred and sixty-five individuals administered to check-up center in Acibadem Fulya Hospital between 2010 and 2020. We retrospectively analyzed the results of those who accepted the FOB test (1432 individuals). We advised colonoscopic examination for patients with FOB test positivity (344 individuals). T understand the predictive role of FOB test, we compared the results according to age, gender, body mass index, and hemoglobin level. Results: Three hundred and forty-four FOB tests were positive out of all 1432 tests. Out of these, only 126 asymptomatic patients accepted the control colonoscopy. There were 21 adenomatous polyps detected in colonoscopic examinations. Statistically higher number of polyps was found after age 50, but two of the patients had adenomatous polyps at age of 45. Discussion and Conclusion: FOB test is a crucial screening test after age of 45. In case of positive result, colonoscopy should be advised. [ABSTRACT FROM AUTHOR]

Objectives: Fecal immunochemical tests (FIT) for hemoglobin are currently considered the screening investigation of choice for colorectal cancer and are worldwide recommended. Similarly, fecal calprotectin is a widely used test for monitoring intestinal inflammation. The pre-analytical issues regarding stool samples have hardly been dealt with and are difficult to solve. Currently, there are no reference analytes available which allow to correct test results for the variable water content of the stool sample. Studies on preanalytics of stool samples have generally focused on sample preparation and sample storage, but generally have paid little attention to the variability in sample hydration and sample composition., Methods: Stercobilin is a stable heme metabolite which is abundant in stool. Stercobilin concentration can be simply assayed in stool extracts using colorimetry (determination of the I index). Serum indices (H, I and L) and bilirubin concentration of fecal extracts were determined on a Atellica Platform (Siemens)., Results: The inter-individual variation of stercobilin was found to be high. Assaying stercobilin allows to correct for stool sample dilution. The median value of the I-index was used as a reference for correcting the data. Correcting fecal blood results for sample dilution resulted in a significant increase in positive tests (from 9.3 to 11.7 %). For calprotectin, correction resulted in 3.1 % extra positive results and 7.7 % negative results., Conclusions: Except in the case of obstructive jaundice, this correction can be applied. Correcting test results of common fecal analytes like FIT and calprotectin may result in a better tailored test interpretation., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: The fecal immunochemistry test (FIT) has been proposed as a surrogate marker of intestinal inflammation. Psoriasis is a chronic inflammatory skin disease that is linked to underlying systemic inflammatory conditions, including inflammatory bowel disease. Methods: We investigated the association between occult blood in feces and the risk of psoriasis using data from the National Health Insurance System. This study was conducted involving 1,395,147 individuals who underwent health examinations from January 2009 to December 2012 and were followed up until the end of 2017. Results: The incidence of psoriasis (per 1,000 person-years) was 3.76 versus 4.14 (FIT-negative versus FIT-positive group) during a median follow-up of 6.68 years. In the multivariable-adjusted model, the hazard ratios for psoriasis were 1.03 for one positive FIT result, 1.12 for two positive FIT results, and 1.34 for three positive FIT results compared with negative FIT results. Conclusion: The risk of psoriasis was significantly increased in patients with positive FIT results compared to the FIT-negative population. [ABSTRACT FROM AUTHOR]

Objective: It was aimed to analyze the relationships between gender, age, and symptom combinations, and the diagnoses determined in colonoscopy. Methods: Demographic data, symptoms, and colonoscopy results of all patients who underwent colonoscopy in our hospital's endoscopy unit in 2018 were obtained from the hospital records and analyzed. Results: The mean age was 54.5±14.6 years. A total of 66.3% of the patients were over 50 years old. A total of 7.3% of colonoscopy procedures could not be completed. In 168 patients (5.4%) there was fecal occult blood (FOB) positivity, 1900 (60.7%) had rectal macroscopical bleeding, 1893 (60.4%) had constipation, and 1975 (63.1%) had abdominal pain. No abnormal findings were found in 1616 (51.6%) of the patients as a result of colonoscopy, 699 (22.3%) had polyps, 43 (1.4%) had cancer-like masses. The polyp detection rate was significantly higher in patients with positive FOB alone (p=0.003) or patients with rectal bleeding and/or constipation (p=0.001) and significantly lower in patients with constipation (p=0.034). The rates of FOB positivity (p<0.001), polyp (p<0.001), cancer-like mass (p=0.008), and diverticular lesions (p<0.001) were significantly higher in the patients over 50 years of age. The rates of polyps (p<0.001) and diverticular lesions (p<0.001) were significantly higher in FOB-positive patients. Conclusion: Findings of the present study showed that patients with FOB positivity or rectal bleeding showed significant pathologies in their colonoscopic examinations, especially over the age of 50, an increase in the rate of the colorectal polyps or cancer-like masses, and a reduced possibility of abnormal findings or malignancies in patients with constipation. [ABSTRACT FROM AUTHOR]

Background & aims: The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC). Methods: Eighty participants with UC were randomly assigned to take, either 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial. Results: Our results indicated significantly increased (p = 0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p = 0.004) whereas red blood cell count (p = 0.01) and hematocrit (p = 0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p = 0.12) and the end of the trial (p = 0.34). Eight weeks of 1 g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo. [ABSTRACT FROM AUTHOR]

Background: Screening with fecal occult blood test reduces colorectal cancer (CRC) incidence and mortality, and is currently implemented in most countries. However, around 40% of screening colonoscopies are normal. Thus, strategies to avoid these colonoscopies are highly necessary. Adding other fecal biomarkers, such as fecal calprotectin (FC), lactoferrin, and transferrin may be useful, but evidence is scarce.Aims: To evaluate the diagnostic accuracy of fecal occult blood immunochemical test (FIT), FC, and a one-step combo card test for the simultaneous semi-qualitative detection of human hemoglobin (hHb), transferrin (hTf), calprotectin (hCp) and lactoferrin (hLf) in a CRC screening program population.Methods: Single-center, prospective observational study, enrolling patients included in a CRC screening program, referred for a colonoscopy due to a positive FIT test. Participants collected a stool sample prior to bowel preparation, and FIT, FC and the combo semi-qualitative tests were performed on the sample. Sensitivity, specificity, positive and negative predictive values and area under receiver operator curve (AUC) for diagnosis of advanced neoplasia, advanced adenoma and CRC were estimated for each biomarker and their combinations. The primary endpoint of the study was to assess whether these biomarkers could improve the diagnostic accuracy of FIT alone.Results: 336 consecutive patients (64% males) were recruited. Advanced neoplasia was found in 129/336 (38.4%) patients, and of these, 22/336 (6.5%) were diagnosed of CRC. 153/336 (45.5%) colonoscopies were completely normal. The AUC for the diagnosis of advanced neoplasia were 0.725 (95%CI 0.665–0.784) for FIT, 0.477 (95%CI 0.413–0.541) for FC and 0.732 (95%CI 0.674–0.791) for the combination of both (FIT + FC) quantitative tests. The AUCs for the combo test were 0.70 (95%CI 0.641–0.760) for hHb, 0.625 (95%CI 0.562–0.698) for hTf, 0.532 (95%CI 0.469–0.595) for hCp, 0.531 (95%CI 0.466–0.595 ) for hLf and 0.681 (95%CI 0.620–0.741) for the combination of the four biomarkers.Conclusion: In average-risk population, FIT appears to be the best fecal marker for the diagnosis of CRC and advanced adenoma. None of the other biomarkers explored or their combinations provided a better diagnostic accuracy. Only hTF showed an acceptable diagnostic accuracy. FC and hLF were not useful in this setting.

Background: Infections with soil-transmitted helminths (STHs) may result in chronic inflammatory disorders affecting the human host. The objective of this study was to evaluate Fecal Calprotectin (FC) and Fecal Occult Blood (FOB) in individuals infected and non-infected with STHs to identify potential intestinal morbidity markers. Methods: Stool from participants diagnosed positive for Trichuris trichiura and concomitant STH infections from three countries was used to perform FC and FOB point-of-care assays. Simultaneously, identified STH negative participants underwent FC and FOB testing as controls. Potential associations between test results and determinants were analyzed using multivariable logistic regression. Findings: In total, 1034 T. trichiura infected cases (mostly light infections) and 157 STH negative controls were tested for FC and FOB. Among all participants tested, 18·5% had ≥ 50 µg/g FC concentration, while 14 (1·2%) were positive for FOB. No statistically significant association was found between T. trichiura infection or Ascaris lumbricoides co-infection and FC concentration, while an inverse association (odds ratio (OR): 0·45, 95% credible intervals (CrI): 0·26, 0·75) was found between hookworm co-infection and FC concentration. In Lao PDR, the proportion of participants in the ≥ 50 µg/g FC category was significantly higher in the oldest age category compared to the 5–11 years group (OR: 3·31, 95% CrI: 1·62, 7·24). Too few participants were found positive for FOB to derive any conclusions. Interpretation: Studies are needed to better understand the relationship between intestinal morbidity and STH infections. Suitable, standardized, low-cost markers of STH attributable morbidity to better monitor the impact of STH control interventions are necessary. Funding: BMGF (OPP1153928)

Objective: Fecal calprotectin (FC) is a promising marker for discrimination of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The search for noninvasive tools for identification of ulcerative colitis (UC), in IBD patients, is still an issue. We aimed to evaluate if combination with other parameters improves the predictive value of FC in UC diagnosis. Material and Method: Patients who underwent FC analysis and that were diagnosed with IBS (n=T21) and IBD (UC, n=186 and Crohn's disease (CD), n=101) were selected for this methodologic study. Logistic regression analysis was used to model the prediction of UC using FC individually or in combination with fecal occult blood (FOB), lymphocyte percent (LP) and neutrophil percent (UP) values. Results: FC, FOB, LP, and NP were significantly different in UC patients compared to both CD and IBS patients. The AUCs of "FC+FOB+UP+NP" and "FC+FOB" models were significantly greater than that of FCfor predicting UC in the entire patient population (AUC=0.789, 0.774 and 0.705, respectively,p<0.05)andinIBDpatients (AUCs=0.755,0.708 and 0.607, respectively, p<0.05). AUCs of "FC+LP"(0.800) and "FC+UP+NP" (0.800) models were significantly greater compared to that of FC (0.756) in predicting IBD in the entire patient population (p<0.05). Conclusion: The combination of inflammatory blood markers and stool biomarkers may provide valuable, non-invasive tools for the identification ofUC in IBS and IBD patients. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the third most prevalent type of cancer in the world. Its prognosis is closely related to the disease stage at the time of diagnosis. Early detection of symptomless CRC or precursor lesions through population screening could reduce CRC mortality. However, screening programs are only effective if enough people are willing to participate. The incidence of CRC has a significantly increasing trend in China. Objective: Evaluation of the necessity of screening colonoscopy for community fecal occult blood-positive patients and exploration of the differences in the epidemiology of colorectal adenomas (CRA) and CRC of community screening patients and patients with different symptoms. Methods: We selected the 40–79 years age group of healthy people in the community of the Fengxian District of Shanghai who had two consecutive fecal occult blood and screening colonoscopies completed in our hospital between June 1, 2014 and October 31, 2014 as the screening group. Patients in the same age group with different symptoms (such as abdominal pain, bloody stool, diarrhea, change in bowel habits, weight loss, anemia, etc.) who had completed colonoscopy in our hospital during the same period comprised up the control group. Differences in the detection rates of colorectal polyps and CRC in the two groups and differences in the detection rates of CRA and early CRC between the two groups were compared. Results: There were 2251 patients in the colonoscopy screening group and 1836 patients in the control group. The colorectal polyps detection rates of the two groups were 19.46% (438/2251) and 21.95% (403/1836), respectively, and the difference was not statistically significant (p = 0.052). The CRC detection rates of the two groups were 0.8% (18/2251) and 2.02% (37/1836), respectively, the difference of which was statistically significant (p = 0.001). The detection rates of CRA were 17.73% (399/2251) and 19.88% (365/1836), respectively, which was not statistically significantly different (p = 0.083). Finally, the detection rates of early CRC were 0.36% (8/2251) and 0.44% (8/1836), respectively, which was not statistically significantly different in the two groups (p = 0.803). Conclusion: The detection rates of CRA among community screening patients and patients with different symptoms were not different. However, the detection rate of CRC in community screening patients was lower than that of the patients with different symptoms. Therefore community colonoscopy screening of fecal occult blood-positive asymptomatic healthy people is necessary, as it can help with the early detection and treatment of CRA. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the methodology of guaiac-based fecal occult blood (FOB) testing in healthy cats, and to examine the effect of feeding selected gastrointestinal diets (canned and dry) on FOB results. Methods: Stool obtained from three cats was mixed with incremental quantities of EDTA whole blood. FOB tests were performed in triplicate and interpreted at 5 mins, and at 24, 48 and 72 h post-test set-up. Ten cats were fed their normal diets, a dry hydrolyzed protein diet, a dry gastrointestinal diet and then transitioned back to their normal diet over a 7-week period. A subsequent study was repeated with similar hydrolyzed protein and gastrointestinal canned diets. Two fecal samples were tested per cat each week using human point-of-care guaiac tests. Results: Ten microliters of whole feline blood could be reliably detected in feline stool at all time points evaluated. There was no evidence of an association between the dry hydrolyzed and dry gastrointestinal diets and a positive FOB test result (P = 0.33). Cats fed a canned gastrointestinal diet had a significantly higher probability of producing a positive FOB result than when on their normal diet (P <0.01). Feeding the canned hydrolyzed diet was not associated with an increased probability of a positive FOB test vs the normal diet (P = 0.94). Conclusions and relevance: Small amounts of blood in feline stool can be reliably and repeatedly detected as early as 5 mins post-FOB test set-up, making this a user-friendly bench-top screening test in a veterinary setting. Cats fed a single dry hydrolyzed, dry gastroenteric or canned hydrolyzed diet in this study had a low chance of false-positive FOB test results, while those fed the canned gastrointestinal diet had a significantly greater likelihood of producing false-positive results. [ABSTRACT FROM AUTHOR]

• Use of guaiac fecal occult blood test (gFOBT) for symptomatic inpatients is often "off-label" in hospitalized patients suspected of gastrointestinal (GI) bleeding. • Fecal Immunochemical Test (FIT) is increasingly replacing gFOBT in the outpatient setting for colorectal cancer screening. • High concordance of gFOBT and FIT could lead to the potential replacement of gFOBT in all settings by FIT. • There is no benefit in delayed analysis of gFOBT for 3 days after sample collection. • FIT provides equivalent results to gFOBT in hospitalized patients. Guaiac fecal occult blood testing (gFOBT) is often used "off-label" for gastrointestinal (GI) bleeding. Fecal Immunochemical Test (FIT) is increasingly replacing gFOBT in colorectal cancer screening and may play a role in assessment for significant bowel disease. We examined the concordance of FIT with gFOBT (Hemoccult Sensa II) among inpatients and between day 1 and day 3 gFOBT results. FIT was performed alongside gFOBT on all inpatient stool sent for occult blood to the Winnipeg Health Sciences Centre laboratory over 1 y. gFOBT was performed on days 1 and 3 post stool collection, while FIT was performed on day 1 only. Positivity rates were highest for Day 1 gFOBT (27.7%), and lowest for FIT (18.3%). Concordance between FIT and Days 1 and 3 gFOBT for negative test results (96.4% and 94.1%) was significantly higher than that expected by chance alone (58.7% and 61.3%, P <.001). Similarly, concordance for positive test results (55.8% and 55.6%) was significantly higher as well as for days 1 and 3 gFOBT results. We found no benefit in delayed testing for 3 days post collection. FIT provides equivalent results to gFOBT in hospitalized patients. [ABSTRACT FROM AUTHOR]

In this paper, a rapid test system with high sensitivity, linearity, and stability is presented for fecal occult blood (FOB) detection. The coloration results of the immune response are used as the basis for the determination of the detection target in combination with an immunochromatographic strip. The rapid test system can be used to detect and calculate the concentration of the sample, so detection of the immune coloration response is more accurate in a quantitative analysis. The system is composed of both hardware and software. The programs used for the analysis and programmed by Python include the main program, polarization calibration, QR Code decoding, Bluetooth transmission, and image processing. After verification of each part of the system, it was found that the rapid test system successfully detects from 0 ng/mL to 400 ng/mL of FOB with coefficients of variation (CV) below 3.7% and 1000 ng/mL with a CV only at 7.41%.

Non-perforating abomasal lesions occur with a high prevalence in slaughtered dairy cattle. Ante mortem diagnosis is a challenge, but the presence of occult blood in feces is suggested as a diagnostic criterion. The lower detection limit of Hemo-Fec® (Med-Kjemi, Asker, Norway) and Hemoccult II® SENSA® (Beckman Coulter, Brea, California, USA) for fecal occult blood were estimated. The Hemo-Fec® and Hemoccult II® SENSA® could detect 1–2 mL and 2–4.5 mL of blood in 1000 g of feces, respectively. Therefore, the Hemo-Fec® test was selected to access hemoglobin degradation in the rumen to establish if blood from outside the gastrointestinal tract could result in false-positive tests and an observational study to estimate the diagnostic sensitivity and specificity. Rumen microbiota did not degrade hemoglobin in a 1% blood concentration in vitro during 48 h of fermentation. The Hemo-Fec® test was only able to detect cattle with ≥4 acute lesions (diagnostic sensitivity: 0.40 [95% confidence interval (95% CI): 0.32–0.48] and ≥4 chronic lesions (sensitivity: 0.44 [95% CI: 0.35–0.52]). The Hemo-Fec® test had no diagnostic potential to detect superficial erosions or scar tissue in abomasa. Furthermore, the specificity was 0.71 [95% CI: 0.68–0.75%], and a positive test is thus not equivalent with abomasal lesions in cattle.

Background: The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods: We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results: Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96), attending a banquet (aOR 2.29; 95% CI, 1.64–3.20), dining out (aOR 1.70; 95% CI, 1.13–2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41), abdominal pain (TR 1.20; 95% CI, 1.07–1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05), winter season (aOR 0.45; 95% CI, 0.28–0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63). Conclusions: Acute bacterial gastroenteritis was highly associated with season, frequency of diarrhea, frequency of vomiting, and eating shrimp or crab.

Background & Aims: The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC)., Methods: Eighty participants with UC were randomly assigned to take, either 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial., Results: Our results indicated significantly increased (p = 0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p = 0.004) whereas red blood cell count (p = 0.01) and hematocrit (p = 0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p = 0.12) and the end of the trial (p = 0.34). Eight weeks of 1 g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo., Conclusions: These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3)., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Colonoscopy is the gold standard for colorectal cancer (CRC) diagnosis and screening, but endoscopy services are usually overburdened. This study aims to investigate the usefulness of fecal hemoglobin (fHb) and calprotectin (FC) for the identification of patients with high probability of CRC who need urgent referral., Methods: In a multicenter prospective study, we enrolled symptomatic patients referred from primary care for colonoscopy. Prior to bowel preparation, fHb and FC quantitative tests were performed. The diagnostic performance was estimated for each biomarker/combination. We built a multivariable predictive model based on logistic regression, translated to a nomogram and a risk calculator to assist clinicians in the decision-making process., Results: The study included 1224 patients, of whom 69 (5.6%) had CRC. At the fHb cut-offs of >0 and 10 μg/g, the negative predictive values for CRC were 98.8% (95% confidence interval 97.8%-99.3%) and 98.6% (95%CI 97.7%-99.1%), and the sensitivities were 85.5% (95%CI 75.0%-92.8%) and 79.7% (95%CI 68.3%-88.4%), respectively. When we added the cut-off of 150 μg/g of FC to both fHb thresholds, the sensitivity of fecal tests improved. In the multivariate logistic regression model, the concentration of fHb was an independent predictor for CRC; age and gender were also independently associated with CRC., Conclusions: fHb and FC are useful as part of a triage tool to identify those symptomatic patients with high probability of CRC. This can be easily applied by physicians to prioritize high-risk patients for urgent colonoscopy., (© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Objective: to determine the sensitivity and specificity of fecal calprotectin and fecal occult blood test (FOBT) for the diagnosis of organic colon pathology. Methods: an observational study was made, which intentionally included 246 patients of both sexes seen at the Japanese Bolivian Gastroenterological Institute of Cochabamba, due to abdominal pain, chronic diarrhea and weight loss. We performed fecal calprotectin and fecal occult blood laboratories, as well as colonoscopy as a control study. Results: it was determined that the fecal calprotectin has a sensitivity of 86%, and specificity of 98%, with an association of 0,54 and a ratio of 0,75 according to the Pearson and Spearman coefficients respectively, in relation to colonoscopy and the diagnosis of organic pathology of colon. The fecal occult blood test showed a sensitivity of 79% but a specificity of 58%, according to the association and relationship with the control minimum of 0,21 and 0,22 according to the Pearson and Spearman coefficients. Conclusions: The results show that fecal calprotectin presents high sensitivity and specificity for the diagnosis of organic colon pathology. Higher values were associated with greater lesion in the colonic mucosa. [ABSTRACT FROM AUTHOR]