Colon Cancer: Sensitivity and Specificity

Introduction: None written.

Prevalence

The sensitivity and specificity of findings for Colon Cancer are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

95%

86%

Sensitivity differs for adenoma size (<5 mm 75%, 6-9mm 85%, >10mm 95%).

Study: USPSTF Modeling Report

https://www.uspreventiveservicestaskforce.org/uspstf/document/modeling-report1/colorectal-cancer-screening

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Fecal Occult Blood Duplicate	5%	97%	single sample from DRE Study: Ann Intern Med. 2005 Jan 18;142(2):81-5. PMID: 15657155
Fecal Occult Blood Duplicate	24%	94%	6-sample Study: Ann Intern Med. 2005 Jan 18;142(2):81-5. PMID: 15657155
Family History of Colon Cancer	16%	91%	Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Rectal Mass	25%	89%	note that sens for abdominal mass = 4% Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Weight	20%	89%	Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Fecal Occult Blood Duplicate	75%	86%	guaiac-based test (note much higher sensitivity here compared to other studies) Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221

Sensitive Findings

Finding	Sensitivity	Specificity	Comments, Study
Fecal Occult Blood Duplicate	95%	84%	immunoassay-based test (note the very high sensitivity here) this was only in secondary referral clinics (probable bias?) Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Secondary Screening Referral Guideline	92%	42%	At least one of the following: Rectal bleeding with a change in bowel habit to looser stools and/or increased frequency of defecation persistent for 6 weeks. Age threshold: all ages. Change in bowel habit as above without rectal bleeding and persistent for 6 weeks. Age threshold: over 60 years. Rectal bleeding persistently without anal symptoms. Age threshold: over 60 years. A definite palpable right-sided abdominal mass. Age threshold: all ages. A definite palpable rectal mass (not pelvic). Age threshold: all ages. Unexplained iron deficiency anaemia. In men: below 11g/dl, all ages. In women: below 10 g/dl, post menopausal. Study:* BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Age Duplicate	91%	36%	Age > 50 Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221

Negative Findings

20%

73%

Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221

13%

72%

Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Age Duplicate	50%	79%	Age > 70 Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Rectal bleeding	44%	66%	for "dark blood" sens=35% / spec=85%; for "mixed with stool" sens=51% / spec=71% Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Changes in Bowel Habits	52%	61%	Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Age Duplicate	83%	55%	Age > 60 Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221
Gender	62%	55%	male Study: BMJ. 2010 Mar 31;340:c1269 PMID: 20360221

Findings With Unspecified Accuracy

No accuracy specified.

Aside from colon cancer, other GI pathology, liver disease and HIV should be considered.

Study: PMID: 16614996

Alazmi W; Bustamante M; O'loughlin C; Gonzalez J; Raskin JB

Dig Dis Sci. 2006 Apr;51(4):732-6.

No accuracy specified.

Carcinoembryonic antigen

Study: no study specified.