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- Title
Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT).
- Authors
Nieuwenburg, S. A. V.; Mommersteeg, M. C.; Wolters, L. M. M.; van Vuuren, A. J.; Erler, N.; Peppelenbosch, M. P.; Fuhler, G. M.; Bruno, M. J.; Kuipers, E. J.; Spaander, M. C. W.
- Abstract
Background: Gastric and colorectal cancer (CRC) are both one of the most common cancers worldwide. In many countries fecal immunochemical tests (FIT)-based CRC screening has been implemented. We investigated if FIT can also be applied for detection of H. pylori, the main risk factor for gastric cancer. Methods: This prospective study included participants over 18 years of age referred for urea breath test (UBT). Patients were excluded if they had used antibiotics/bismuth in the past 4 weeks, or a proton pomp inhibitor (PPI) in the past 2 weeks. Participants underwent UBT, ELISA stool antigen test in standard feces tube (SAT), ELISA stool antigen test in FIT tube (Hp-FIT), and blood sampling, and completed a questionnaire on user friendliness. UBT results were used as reference. Results: A total of 182 patients were included (37.4% male, median age 52.4 years (IQR 22.4)). Of these, 60 (33.0%) tested H. pylori positive. SAT and Hp-FIT showed comparable overall accuracy 71.1% (95%CI 63.2–78.3) vs. 77.6% (95%CI 70.4–83.8), respectively (p = 0.97). Sensitivity of SAT was 91.8% (95%CI 80.4–97.7) versus 94.2% (95%CI 84.1–98.9) of Hp-FIT (p = 0.98). Serology scored low with an overall accuracy of 49.7% (95%CI 41.7–57.7). Hp-FIT showed the highest overall user convenience. Conclusions: FIT can be used with high accuracy and sensitivity for diagnosis of H. pylori and is rated as the most convenient test. Non-invasive Hp-FIT test is highly promising for combined upper and lower gastrointestinal (pre-) cancerous screening. Further research should investigate the clinical implications, benefits and cost-effectiveness of such an approach.
- Subjects
HELICOBACTER pylori; HELICOBACTER pylori infections; ANTIGENS; STOMACH cancer; MEDICAL screening; BREATH tests
- Publication
Gastric Cancer, 2022, Vol 25, Issue 2, p375
- ISSN
1436-3291
- Publication type
Article
- DOI
10.1007/s10120-021-01264-8