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News

Comparison of fecal immunochemical tests in colorectal cancer screening

The latest issue of Gut compares fecal immunochemical tests in colorectal cancer screening.

News image

Colorectal cancer screening programs are implemented worldwide.

Many are based on fecal immunochemical testing.

Dr Grobbee and colleagues from the Netherlands evaluated 2 frequently used fecal immunochemical testing on participation, usability, positivity rate and diagnostic yield in population-based fecal immunochemical testing screening.

Comparison of 2 fecal immunochemical tests was performed in a fourth round population-based fecal immunochemical test-screening cohort.

Randomly selected individuals aged 50–74 were invited for fecal immunochemical test screening and were randomly allocated to receive an OC-Sensor or fecal occult blood-Gold test.

A cut-off of 10 µg hemoglobin per gram of feces was used for both fecal immunochemical testings.

Positivity rate was 7% for fecal occult blood-Gold
Gut

In total, 19,291 eligible invitees were included.

Of these, 9669 invitees received OC-Sensor and 9622 fecal occult blood-Gold.

The research team found that both tests were returned by 63% of invitees.

The team noted that tests were non-analyzable in less than 1% of participants using OC-Sensor vs 2% using fecal occult blood-Gold.

Positivity rate was 8% for OC-Sensor, and 7% for fecal occult blood-Gold.

The research team observed no significant difference in diagnostic yield of advanced neoplasia or positive predictive value.

When comparing both tests at the same positivity rate instead of cut-off, they yielded similar positive predictive values and detection rates.

Dr Grobbee's team concludes, "The OC-Sensor and fecal occult blood-Gold were equally acceptable to a screening population."

"However, fecal occult blood-Gold was prone to more non-analyzable tests."

"Comparison between fecal immunochemical testing brands is usually done at the same hemoglobin stool concentration."

"Our findings imply that for a fair comparison on diagnostic yield between fecal immunochemical testing's positivity rate rather than hemoglobin concentration should be used."

Gut 2017;66:1975-1982
19 October 2017

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