Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT)

S. A.V. Nieuwenburg; M. C. Mommersteeg; L. M.M. Wolters; A. J. van Vuuren; N. Erler; M. P. Peppelenbosch; G. M. Fuhler; M. J. Bruno; E. J. Kuipers; M. C.W. Spaander

doi:10.1007/s10120-021-01264-8

Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT)

S. A.V. Nieuwenburg, M. C. Mommersteeg, L. M.M. Wolters, A. J. van Vuuren, N. Erler, M. P. Peppelenbosch, G. M. Fuhler, M. J. Bruno, E. J. Kuipers, M. C.W. Spaander^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Gastric and colorectal cancer (CRC) are both one of the most common cancers worldwide. In many countries fecal immunochemical tests (FIT)-based CRC screening has been implemented. We investigated if FIT can also be applied for detection of H. pylori, the main risk factor for gastric cancer. Methods: This prospective study included participants over 18 years of age referred for urea breath test (UBT). Patients were excluded if they had used antibiotics/bismuth in the past 4 weeks, or a proton pomp inhibitor (PPI) in the past 2 weeks. Participants underwent UBT, ELISA stool antigen test in standard feces tube (SAT), ELISA stool antigen test in FIT tube (Hp-FIT), and blood sampling, and completed a questionnaire on user friendliness. UBT results were used as reference. Results: A total of 182 patients were included (37.4% male, median age 52.4 years (IQR 22.4)). Of these, 60 (33.0%) tested H. pylori positive. SAT and Hp-FIT showed comparable overall accuracy 71.1% (95%CI 63.2–78.3) vs. 77.6% (95%CI 70.4–83.8), respectively (p = 0.97). Sensitivity of SAT was 91.8% (95%CI 80.4–97.7) versus 94.2% (95%CI 84.1–98.9) of Hp-FIT (p = 0.98). Serology scored low with an overall accuracy of 49.7% (95%CI 41.7–57.7). Hp-FIT showed the highest overall user convenience. Conclusions: FIT can be used with high accuracy and sensitivity for diagnosis of H. pylori and is rated as the most convenient test. Non-invasive Hp-FIT test is highly promising for combined upper and lower gastrointestinal (pre-) cancerous screening. Further research should investigate the clinical implications, benefits and cost-effectiveness of such an approach.

Original language	English
Pages (from-to)	375-381
Number of pages	7
Journal	Gastric Cancer
Volume	25
Issue number	2
DOIs	https://doi.org/10.1007/s10120-021-01264-8
Publication status	Published - Mar 2022

Bibliographical note

Acknowledgements
The authors would like to acknowledge B.H.C.M. Roovers, J. Francke, M. Ouwendijk and F. van Deurzen for their assistance in the execution of the tests in the Erasmus MC. We would also like to acknowledge A. van Liere-Baron for her assistance in organizational tasks and logistics at the Albert Schweitzer Hospital. This study was supported by the Dutch Digestive Foundation (D18-02).

Publisher Copyright: © 2021, The Author(s).

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@article{4cb790f90de146e0a24a181ce4516466,

title = "Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT)",

abstract = "Background: Gastric and colorectal cancer (CRC) are both one of the most common cancers worldwide. In many countries fecal immunochemical tests (FIT)-based CRC screening has been implemented. We investigated if FIT can also be applied for detection of H. pylori, the main risk factor for gastric cancer. Methods: This prospective study included participants over 18 years of age referred for urea breath test (UBT). Patients were excluded if they had used antibiotics/bismuth in the past 4 weeks, or a proton pomp inhibitor (PPI) in the past 2 weeks. Participants underwent UBT, ELISA stool antigen test in standard feces tube (SAT), ELISA stool antigen test in FIT tube (Hp-FIT), and blood sampling, and completed a questionnaire on user friendliness. UBT results were used as reference. Results: A total of 182 patients were included (37.4% male, median age 52.4 years (IQR 22.4)). Of these, 60 (33.0%) tested H. pylori positive. SAT and Hp-FIT showed comparable overall accuracy 71.1% (95%CI 63.2–78.3) vs. 77.6% (95%CI 70.4–83.8), respectively (p = 0.97). Sensitivity of SAT was 91.8% (95%CI 80.4–97.7) versus 94.2% (95%CI 84.1–98.9) of Hp-FIT (p = 0.98). Serology scored low with an overall accuracy of 49.7% (95%CI 41.7–57.7). Hp-FIT showed the highest overall user convenience. Conclusions: FIT can be used with high accuracy and sensitivity for diagnosis of H. pylori and is rated as the most convenient test. Non-invasive Hp-FIT test is highly promising for combined upper and lower gastrointestinal (pre-) cancerous screening. Further research should investigate the clinical implications, benefits and cost-effectiveness of such an approach.",

author = "Nieuwenburg, {S. A.V.} and Mommersteeg, {M. C.} and Wolters, {L. M.M.} and {van Vuuren}, {A. J.} and N. Erler and Peppelenbosch, {M. P.} and Fuhler, {G. M.} and Bruno, {M. J.} and Kuipers, {E. J.} and Spaander, {M. C.W.}",

note = "Acknowledgements The authors would like to acknowledge B.H.C.M. Roovers, J. Francke, M. Ouwendijk and F. van Deurzen for their assistance in the execution of the tests in the Erasmus MC. We would also like to acknowledge A. van Liere-Baron for her assistance in organizational tasks and logistics at the Albert Schweitzer Hospital. This study was supported by the Dutch Digestive Foundation (D18-02). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2022",

month = mar,

doi = "10.1007/s10120-021-01264-8",

language = "English",

volume = "25",

pages = "375--381",

journal = "Gastric Cancer",

issn = "1436-3291",

publisher = "Springer Japan",

number = "2",

}

TY - JOUR

T1 - Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT)

AU - Nieuwenburg, S. A.V.

AU - Mommersteeg, M. C.

AU - Wolters, L. M.M.

AU - van Vuuren, A. J.

AU - Erler, N.

AU - Peppelenbosch, M. P.

AU - Fuhler, G. M.

AU - Bruno, M. J.

AU - Kuipers, E. J.

AU - Spaander, M. C.W.

N1 - Acknowledgements The authors would like to acknowledge B.H.C.M. Roovers, J. Francke, M. Ouwendijk and F. van Deurzen for their assistance in the execution of the tests in the Erasmus MC. We would also like to acknowledge A. van Liere-Baron for her assistance in organizational tasks and logistics at the Albert Schweitzer Hospital. This study was supported by the Dutch Digestive Foundation (D18-02). Publisher Copyright: © 2021, The Author(s).

PY - 2022/3

Y1 - 2022/3

N2 - Background: Gastric and colorectal cancer (CRC) are both one of the most common cancers worldwide. In many countries fecal immunochemical tests (FIT)-based CRC screening has been implemented. We investigated if FIT can also be applied for detection of H. pylori, the main risk factor for gastric cancer. Methods: This prospective study included participants over 18 years of age referred for urea breath test (UBT). Patients were excluded if they had used antibiotics/bismuth in the past 4 weeks, or a proton pomp inhibitor (PPI) in the past 2 weeks. Participants underwent UBT, ELISA stool antigen test in standard feces tube (SAT), ELISA stool antigen test in FIT tube (Hp-FIT), and blood sampling, and completed a questionnaire on user friendliness. UBT results were used as reference. Results: A total of 182 patients were included (37.4% male, median age 52.4 years (IQR 22.4)). Of these, 60 (33.0%) tested H. pylori positive. SAT and Hp-FIT showed comparable overall accuracy 71.1% (95%CI 63.2–78.3) vs. 77.6% (95%CI 70.4–83.8), respectively (p = 0.97). Sensitivity of SAT was 91.8% (95%CI 80.4–97.7) versus 94.2% (95%CI 84.1–98.9) of Hp-FIT (p = 0.98). Serology scored low with an overall accuracy of 49.7% (95%CI 41.7–57.7). Hp-FIT showed the highest overall user convenience. Conclusions: FIT can be used with high accuracy and sensitivity for diagnosis of H. pylori and is rated as the most convenient test. Non-invasive Hp-FIT test is highly promising for combined upper and lower gastrointestinal (pre-) cancerous screening. Further research should investigate the clinical implications, benefits and cost-effectiveness of such an approach.

AB - Background: Gastric and colorectal cancer (CRC) are both one of the most common cancers worldwide. In many countries fecal immunochemical tests (FIT)-based CRC screening has been implemented. We investigated if FIT can also be applied for detection of H. pylori, the main risk factor for gastric cancer. Methods: This prospective study included participants over 18 years of age referred for urea breath test (UBT). Patients were excluded if they had used antibiotics/bismuth in the past 4 weeks, or a proton pomp inhibitor (PPI) in the past 2 weeks. Participants underwent UBT, ELISA stool antigen test in standard feces tube (SAT), ELISA stool antigen test in FIT tube (Hp-FIT), and blood sampling, and completed a questionnaire on user friendliness. UBT results were used as reference. Results: A total of 182 patients were included (37.4% male, median age 52.4 years (IQR 22.4)). Of these, 60 (33.0%) tested H. pylori positive. SAT and Hp-FIT showed comparable overall accuracy 71.1% (95%CI 63.2–78.3) vs. 77.6% (95%CI 70.4–83.8), respectively (p = 0.97). Sensitivity of SAT was 91.8% (95%CI 80.4–97.7) versus 94.2% (95%CI 84.1–98.9) of Hp-FIT (p = 0.98). Serology scored low with an overall accuracy of 49.7% (95%CI 41.7–57.7). Hp-FIT showed the highest overall user convenience. Conclusions: FIT can be used with high accuracy and sensitivity for diagnosis of H. pylori and is rated as the most convenient test. Non-invasive Hp-FIT test is highly promising for combined upper and lower gastrointestinal (pre-) cancerous screening. Further research should investigate the clinical implications, benefits and cost-effectiveness of such an approach.

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U2 - 10.1007/s10120-021-01264-8

DO - 10.1007/s10120-021-01264-8

M3 - Article

C2 - 34792700

AN - SCOPUS:85119285171

VL - 25

SP - 375

EP - 381

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

IS - 2

ER -

Accuracy of H. pylori fecal antigen test using fecal immunochemical test (FIT)

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