Sensitivity and Specificity of Colorectal Cancer Mass Screening Methods: A Systematic Review of the Literature

Background: Colorectal cancer is the second cause of the cancer related mortalities in the world. Screening can effectively reduce the mortality and morbidity rate of this cancer. Sensitivity and specificity of screening methods play an important role in their efficacy. The aim of this study is to review sensitivity and specificity of selected colorectal cancer screening methods systematically. Methods: This study conducted a systematic review of sensitivity and specificity of five common colorectal cancer screening methods. The sites Pubmed, Cochrane library and the center for review and dissemination (CRD database) were searched systematically in Jan 2009. Key questions for this search were focused on the sensitivity and specificity of the 5 screening methods. Results: In these databases 2713 articles were matched well with our subject. Of these 130 articles were selected with specified inclusion-exclusion criteria. The mean ± standard deviation per patient sensitivities of colonoscopy, sigmoidoscopy, double contrast barium enema, CT colonography and fecal occult blood test for detecting colorectal cancer were respectively 94.7 ± 4.6 %, 82.0± 9.3%, 82.3 ± 8.7 % , 95.7 ±5.9% and 45.7 ± 26.5% . Specificities of these tests were respectively 99.8 ± 0.2%, 83.9%, 92.4 ± 14.7%, 98.5 ± 1.3% and 87.6 ± 11.4%. Conclusions: Based on available evidences, colonoscopy has the highest sensitivity and specificity among the selected screening methods and fecal occult blood test has the lowest sensitivity. Almost all of the tests except stool exams have acceptable sensitivity and specificity for detecting colorectal cancer.