SENSITIVITY and SPECIFICITY can be confusing. But they are important parameters of biomedical testing. In Colorectal Cancer (CRC), it's critical. More than 30,000 people die in the US each year due to failure to screen for CRC. Why? The definitive screen is colonoscopy. It requires putting the patient to sleep, using an operating room, and days of bowel preparation requiring drinking gallons of fluid. So many home tests have been developed, ranging from FOBT (fecal occult blood testing), FIMT ( fecal immunochemical blood testing), and fecal DNA testing. The FOBT and FIMT tests are inexpensive and practical. But they are not sensitive. Test sensitivity equals the number of true positive tests over the total with the disease. ( Total with disease includes TRUE POSITIVES plus FALSE NEGATIVES). The reason is simple; colorectal cancers do not always bleed. If they are not bleeding, the FOBT will be a false negative. FIMT is often a false negative as well.
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