The role of fecal mRNA cyclooxygenase 2 and fecal immunochemical test to detect colorectal cancer

Background: Endoscopy is the standard method of screening, but it is considered invasive, requires sedation and need particular colonic preparation. Fecal immunochemical test (FIT) is a test using an immunoassay to detect the globin protein in feces and can be non-invasive modality for the detection of colorectal cancer. Fecal mRNA COX-2 is also the non-invasive modality to detect neoplastic lesion of colorectal. Objective: Analyzing the accuracy of fecal mRNA COX-2 and FIT in diagnosing colorectal cancer. Methods: This is a cross sectional study in patient who is suspected colorectal cancer. Fecal mRNA COX-2 and fecal immunochemical test were carried out on the subject fecal samples and the results were analyzed to obtain the diagnostic test’s accuracy. Results: There were 96 total samples included in this research with the mean age of 56,22 years old. There were 51 male subjects and 45 female subjects 14 subjects with colorectal cancer and 82 subjects without colorectal cancer. The diagnostic accuracy of mRNA COX-2 and FIT are the following; AUC 0.654 (95% CI 0.477–0.831), AUC 0.711 (95% CI 0.562–0.860). After further analysis, the diagnostic accuracy of combined mRNA COX-2 and FIT is AUC 0.839 (95% CI 0.734–0.944). Conclusion: Fecal immunochemical test has better accuracy than mRNA COX-2. Accuracy after combinating mRNA COX-2 and FIT increases when compared with single diagnostic tool to detect colorectal cancer.