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 |