• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.17-22
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• 2016

Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor's advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P<0.01, Exp(B)= 1.9) and self-efficacy (P<0.01, Exp(B)= 1.6) were predictive factors related to occult blood testing among subjects. The results showed that reducing people's perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.195-198
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• 2012

To date, there was no controlled-study regarding awareness and knowledge of colorectal cancer in the Turkish population. We therefore designed a questionnaire consisting of items related to socio-demographic parameters, medical and family history and questions of awareness and knowledge about colorectal cancer for use in a descriptive cross-sectional study. An interviewer-administered technique was applied and 450 subjects were interviewed in the outpatient clinics at Near East University Hospital. Among all subjects, 337 were found to be eligible for the study group. Exclusion criteria were age below 18 years, any cancer history, family history of colorectal cancer, current colorectal problems, history of any diagnostic or therapeutic interventions for colorectal diseases. All participants stated that they heard about colorectal cancer. When asked about the lifetime risk of colorectal carcinoma, only 25.4% of women and 37.9% of men estimated correctly. Univariate analysis revealed that the total awareness score was significantly correlated with age, marital status, parenthood and fecal occult blood testing history. On multivariate analysis of independent predictors for awareness of colorectal cancer were found to be history of fecal occult blood testing, age and marital status were found to be the most important determinants. As a conclusion, opportunistic screening with fecal occult blood test by physicians from non-gastrointestinal specialties not only helps to reduce the mortality but also increases the awareness of colorectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.237-241
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• 2012

Objective: Screening for colorectal cancer using guaiac-based fecal occult blood tests (gFOBT) is well established in Western populations, but is hampered by poor patient compliance due to the imposed dietary restrictions. Fecal immunochemical tests (FIT) do not require dietary restriction, but are more expensive than gFOBT and therefore restrict its use in developing countries in Asia. However, Asian diets being low in meat content may not require diet restriction for gFOBT to achieve equivalent results. The objective of this study was to evaluate and compare the validity and suitability of gFOBT and FIT or a combination of the two in screening for colorectal neoplasias without prior dietary restriction in an Asian population. Methods: Patients referred to the Endoscopic Unit for colonoscopy were recruited for the study. Stool samples were collected prior to bowel preparation, and tested for occult blood with both gFOBT and FIT. Dietary restriction was not imposed. To assess the validity of either tests or in combination to detect a neoplasm or cancer in the colon, their false positive rates, their sensitivity (true positive rate) and the specificity (true negative rate) were analyzed and compared. Results: One hundred and three patients were analysed. The sensitivity for picking up any neoplasia was 53% for FIT, 40% for gFOBT and 23.3% for the combination. The sensitivities for picking up only carcinoma were 77.8%, 66.7% and 55.5%, respectively. The specificity for excluding any neoplasia was 91.7% for FIT, 74% for gFOBT and 94.5% for a combination, whereas for excluding only carcinomas they were 84%, 73.4% and 93.6%. Of the 69 with normal colonoscopic findings, FOBT was positive in 4.3%, 23.2 %and 2.9% for FIT, gFOBT, or combination of tests respectively. Conclusion: FIT is the recommended method if we are to dispense with dietary restriction in our patients because of its relatively low-false positivity and better sensitivity and specificity rates.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.225-229
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• 2016

Background: It is important to validate scales related to cancer screening beliefs in order to better understand perceptions. The aim of this study was to test the psychometric properties of the colorectal cancer screening belief scale based on Health Belief Model (HBM) constructs. Materials and Methods: Data were collected from 600 persons referred to outpatient laboratory units in Iran through a convenience sampling procedure. In this cross-sectional study, exploratory and confirmatory factor analyses were used to examine construct validity of scale. Results: Through exploratory factor analysis, 52 items of the scale converged to five constructs of HBM with 4 items omission. Construct validity was determined by confirmatory factor analysis through which correlated model was supported. Cronbach's alpha coefficient for the whole scale was obtained as 0.78, which indicates reliability of the scale. Conclusions: The study findings showed that this scale is a valid and reliable instrument that can be used for measuring HBM constructs about colorectal cancer screening with the fecal occult blood test.

• Analytical Science and Technology
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• v.17 no.3
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• pp.211-216
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• 2004

Commercial one-step rapid fecal occult blood (FOB) kit which was used as a screening test to detect traces of blood in stool samples was evaluated for the feasibility of the forensic identification of human blood. The sensitivity was determined and compared with the conventional Leucomalichite green (LMG) method. In addition, the specificity of the kit and the effects of various chemicals and environmental factors were examined. FOB kit was specific for human hemoglobin and more sensitive than LMG test (approximately 100 times). FOB kit showed positive band using at least 1,000,000-fold diluted human blood. The antigen was very stable regardless of storage temperature and boiling. The positive reaction was not affected by LMG and Luminol, the traditional tests for identification of bloodstain. As a results, FOB test kit could be effectively applied to identification of human blood at crime scene and crime laboratories.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7981-7984
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• 2014

Purpose: Colorectal cancer (CRC) screening with fecal occult blood testing (FOBT) has been associated with a reduction in CRC incidence and CRC-related mortality. However, a conventional FOBT requires stool collection and handling, which may be inconvenient for participants. The EZ-Detect$^{TM}$ (Siam Pharmaceutical Thailand) is a FDA-approved chromogen-substrate based FOBT which is basically a self-checked FOBT (no stool handling required). This study aimed to evaluate the accuracy of EZ-Detect for CRC detection. Methods: This prospective study was conducted in the Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand between November 2013 and May 2014. Some 96 patients with histologically-proven CRC and 101 patients with normal colonoscopic findings were invited to perform self-checked FOBT according to the manufacturer's instructions. Results were compared with endoscopic and pathologic findings. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC detection were calculated. Results: The present study revealed the sensitivity, specificity, PPV and NPV of this self-checked FOBT for CRC detection to be 41% (95% CI: 31-51), 97% (95% CI: 92-99), 93% (95% CI: 81-98) and 63% (95% CI: 55-70), respectively. The overall accuracy of the self-checked FOBT for identifying CRC was 70%. The sensitivity for CRC detection based on 7th AJCC staging was 29% for stage I, 32% for stage II and 50% for stage III/IV (P=0.19). The sensitivity was 33% for proximal colon and 42% for distal colon and rectal cancer (P=0.76). Notably, none of nine infiltrative lesions gave a positive FOBT. Conclusions: The self-checked FOBT had an acceptable accuracy of CRC detection except for infiltrative tumors. This home-administrated or 'DIY' do-it-yourself FOBT could be considered as one non-invasive and convenient tool for CRC screening.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• BMB Reports
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• v.41 no.10
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• pp.685-692
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• 2008

Colorectal cancer (CRC) is the third most common malignancy in the world. Because CRC develops slowly from removable precancerous lesions, detection of the disease at an early stage during regular health examinations can reduce both the incidence and mortality of the disease. Although sigmoidoscopy offers significant improvements in the detection rate of CRC, its diagnostic value is limited by its high costs and inconvenience. Therefore, there is a compelling need for the identification of noninvasive biomarkers that can enable earlier detection of CRC. Accordingly, many validation studies have been conducted to evaluate genetic, epigenetic or protein markers that can be detected in the stool or in serum. Currently, the fecal-occult blood test is the most widely used method of screening for CRC. However, advances in genomics and proteomics combined with developments in other relevant fields will lead to the discovery of novel non invasive biomarkers whose usefulness will be tested in larger validation studies. Here, non-invasive molecular biomarkers that are currently used in clinical settings and have the potential for use as CRC biomarkers are discussed.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.17-20
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• 2016

Colorectal cancer is the 2^nd most common cancer in men, and the 3^rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

• Journal of Biosystems Engineering
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• v.38 no.2
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• pp.121-128
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• 2013

Purpose: Porcine proliferative enteropathy (PPE), caused by the obligate intracellular bacterium Lawsonia intracellularis, is a widely distributed disease throughout the world causing substantial economic loss. In order to diagnose PPE rapidly, the rapid kit was developed and tested. Methods: In this study, a rapid kit was developed to screen the PPE rapidly at the pig farm. Also, occult blood test with fecal occult blood (FOB) kit was done for detecting the blood in pig feces which might be the evident of hemorrhagic PPE. For developing the kit, we tested fecal samples of PPE infected pigs diagnosed by polymerase chain reaction (PCR) method. Results: With the developed rapid kit, Lawsonia intracellularis was detected in high density emulsion of ileum. On the other hand, the test result of detecting Lawsonia in feces showed too high non-specific response. In addition, nevertheless the FOB test result showed that blood evident could be founded in pig feces, the diagnosing result was not fit to PCR test result, which shows blood in pig feces could be from not only hemorrhagic PPE but also many reasons. Conclusions: To deal with the PPE effectively, it will be better for farmers to screen the PPE in earlier stage with easy and rapid diagnosing tool on farm. This study found out that the rapid kit could detect the Lawsonia intracellularis and hemoglobin in pig feces. However, the non-specific response to negative samples of PPE was too high to use at a pig farm. Further research is needed for lowering the non-specific response with the rapid kit.