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Table 3 Serious clinical events with suspicion of cancer recurrence

From: A prospective analysis of false positive events in a National Colon Cancer Surveillance Program

Serious clinical event characteristics

Surgeon-surveillance

GP-surveillance

Total

p value

Surveillance (months)

942

942

1884

ns

Interval SCE

12

13

25

ns

Routine SCE

11

12

23

ns

Total SCE

22

26

48

ns

Symptom initiated SCE

 

Abdominal pain (n)

3

11

14

0.05

Blood in stool (n)

6

4

10

ns

Anaemia (n)

0

1

1

ns

Weight loss (n)

1

1

2

ns

Lymphadenopathy (n)

2

0

2

ns

Other findings (n)

1

1

2

ns

Total

13

18

31

ns

True cancer recurrence

4

3

7

ns

Test initiated SCE

 

Elevated CEA

2

4

6

ns

Radiology

6

3

9

ns

Colonoscopy

1

1

2

ns

Total

9

8

17

ns

True cancer recurrence

4

3

7

ns

False positive tests and symptoms (%)

14 (25%)

20 (36%)

34 (31%)

ns

Program positive predictive value

0.36

0.23

0.29

ns

Diagnostics for potential recurrent cancer

 

CEA (repeated)

2

4

7

ns

Chest x-ray

4

3

6

ns

CEUS

2

6

6

ns

Colonoscopy

3

12

15

0.05

CT thorax/abdomen/liver

13

8

21

ns

PET

0

2

2

ns

Consultations

14

23

37

ns

Diagnostic work-up days (SD)

45 (45)

35 (28)

39 (35)

ns

  1. PPV: positive predictive value, which is the proportion of positive test/clinical findings that are true positives (i.e., true cancer recurrences). ns: not significant.