Current noninvasive tests for colorectal cancer screening: An overview of colorectal cancer screening tests

Table 1 The sensitivity and specificity of qualitative and quantitative fecal immunochemical test

Qualitative FIT					Quantitative FIT
Ref.	Total cases	CRCcases	Sensitivity	Specificity	Ref.	Total cases	CRC cases	Sensitivity	Specificity
Allison et al[12], 1996	7493	35	0.69	0.94	Sohn et al[22], 2005	3794	12	0.25	0.99
Allison et al[15], 2007	5356	14	0.86	0.97	Levi et al[23], 2011	1204	6	1.00	0.88
Cheng et al[16], 2002	7411	16	0.88	0.91	Levi et al[24], 2007	80	3	0.67	0.83
Nakama et al[17], 1999	4611	18	0.56	0.97	Morikawa et al[25], 2005	21805	79	0.66	0.95
Nakama et al[18], 1996	3365	12	0.83	0.96	Launoy et al[26], 2005	7421	28	0.86	0.94
Parra-Blanco et al[19], 2010	1756	14	1.00	0.93	Itoh et al[27], 1996	27860	89	0.87	0.95
Chiu et al[20], 2013	8822	13	0.85	0.92	Nakazato et al[28], 2006	3090	19	0.53	0.87
Chiang et al[21], 2011	2796	28	0.96	0.87	Park et al[29], 2010	770	13	0.77	0.94
					de Wijkerslooth et al[30], 2012	1256	8	0.75	0.95
					Brenner et al[31], 2013	2235	15	0.73	0.96
					Brenner et al[31], 2013	2235	15	0.60	0.95
Overall (pooled data)	41610	150	0.82	0.93		71750	287	0.73	0.95

CRC: Colorectal cancer; FIT: Fecal immunochemical test.

Table 2 Comparison of sensitivity and specificity between Cologuard and fecal immunochemical test

	Pathological categories	Cologuard	FIT
Sensitivity[32]	CRC	92.3%	73.8%
	Advanced precancerous lesions	42.4%	23.8%
	Polyps with high-grade dysplasia	69.2%	46.2%
	Serrated sessile polyps	42.4%	5.1%
Specificity[32]	Nonadvanced or negative findings	86.6%	94.9%
	Negative results on colonoscopy	89.8%	96.4%

CRC: Colorectal cancer; FIT: Fecal immunochemical test.

Table 3 The reported positive detection rate for each colorectal cancer stage using 1/3 algorithm

Ref.	Positive detection rate for each colorectal cancer stage
	I	II	III	IV
deVos et al[38], 2009	52.6% (10/19)	75.0% (30/40)	77.8% (21/27)	100.0% (4/4)
Warren et al[40], 2011	71.4% (5/7)	90.3% (28/31)	100.0% (7/7)	100% (5/5)
Tóth et al[41], 2012	84.0% (21/25)	100.0% (14/14)	100.0% (35/35)	100.0% (18/18)
Lee et al[47], 2013	30.8% (8/26)	36.7% (11/30)	25.0% (7/28)	64.7% (11/17)
Johnson et al[44], 2014	61.5% (16/26)	80.0% (16/20)	65.2% (15/23)	92.3% (12/13)
Pooled positive detection rate	58.3% (60/103)	73.3% (99/135)	70.8% (85/120)	87.7% (50/57)

Table 4 The reported positive detection rate for each colorectal cancer stage using 2/3 algorithm

Ref.	Positive detection rate for each colorectal cancer stage
	I	II	III	IV
Grützmann et al[37], 2008	50.0% (11/22)	69.4% (25/36)	79% (42/53)	91% (10/11)
deVos et al[38], 2009	26.3% (5/19)	60.0% (24/40)	66.7% (18/27)	75.0% (3/4)
Tóth et al[41], 2012	60.0% (15/25)	92.8% (13/14)	81.6% (31/35)	77.8% (14/18)
Jin et al[46], 2015	66.7% (12/18)	82.6% (19/23)	84.1% (37/44)	100.0% (5/5)
Pooled positive detection rate	51.2% (43/84)	71.7% (81/113)	80.5% (128/159)	84.2% (32/38)

Table 5 Sensitivity and specificity of fecal immunochemical test, fecal DNA and SEPT9 tests in colorectal cancer and advanced adenoma screening

	FIT[12,15-31]	Fecal DNA[32]	SEPT9[43]
Sensitivity (CRC)	79%	92%	68%
Specificity	94%	87%	80%
Sensitivity (AA)	24%	42%	18%

FIT: Fecal immunochemical test; CRC: Colorectal cancer; AA: Advanced adenoma.

Table 6 Positive detection rate of SEPT9, fecal immunochemical test and carcino-embryonic antigen tests and various combined tests

SEPT9alone	FIT alone	CEA alone	SEPT9 + FIT	SEPT9 + CEA	FIT + CEA	SEPT9 + FIT + CEA
77.00%	74.6% (NS)	41.3%e	94.4%c	86.4%c	84.5% (NS)	97.2%e
(181/235)	(53/71)	(97/235)	(67/71)	(203/235)	(60/71)	(69/71)

^cP < 0.01;

^eP < 0.001 vs SEPT9 alone. FIT: Fecal immunochemical test; CEA: Carcino-embryonic antigen; NS: Not significant.