TY - JOUR AU - Redwood, Diana AU - Provost, Ellen AU - Asay, Elvin AU - Roberts, Diana AU - Haverkamp, Donald AU - Perdue, David PY - 2014 TI - Comparison of Fecal Occult Blood Tests for Colorectal Cancer Screening in an Alaska Native Population With High Prevalence of Helicobacter pylori Infection, 2008-2012 T2 - Preventing Chronic Disease JO - Prev Chronic Dis SP - E56 VL - 11 CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. N2 - INTRODUCTION Alaska Native colorectal cancer (CRC) incidence and mortality rates are the highest of any ethnic/racial group in the United States. CRC screening using guaiac-based fecal occult blood tests (gFOBT) are not recommended for Alaska Native people because of false-positive results associated with a high prevalence of Helicobacter pylori-associated hemorrhagic gastritis. This study evaluated whether the newer immunochemical FOBT (iFOBT) resulted in a lower false-positive rate and higher specificity for detecting advanced colorectal neoplasia than gFOBT in a population with elevated prevalence of H. pylori infection. METHODS We used a population-based sample of 304 asymptomatic Alaska Native adults aged 40 years or older undergoing screening or surveillance colonoscopy (April 2008-January 2012). RESULTS Specificity differed significantly (P < .001) between gFOBT (76%; 95% CI, 71%-81%) and iFOBT (92%; 95% CI, 89%-96%). Among H. pylori-positive participants (54%), specificity of iFOBT was even higher (93% vs 69%). Overall, sensitivity did not differ significantly (P = .73) between gFOBT (29%) and iFOBT (36%). Positive predictive value was 11% for gFOBT and 32% for iFOBT. CONCLUSION The iFOBT had a significantly higher specificity than gFOBT, especially in participants with current H. pylori infection. The iFOBT represents a potential strategy for expanding CRC screening among Alaska Native and other populations with elevated prevalence of H. pylori, especially where access to screening endoscopy is limited. SN - 1545-1151 UR - http://dx.doi.org/10.5888/pcd11.130281 DO - 10.5888/pcd11.130281 ER -