A joint committee was established to review published data on the performance of fecal occult blood tests (FOBTs) in order to provide recommendations for their effective use in screening for colorectal cancer.
The committee represented the World Health Organization and the World Organization for Digestive Endoscopy.
The team performed a systematic review of published evidence for FOBT performance.
Inclusion criteria for this study were based on experimental design, cohort size, and performance variables reported.
The Hemoccult SENSA guiac test had the highest sensitivity for cancer and adenomas but a high test positivity.
|Newer guaiac test shows highest sensitivity for cancer.|
|American Journal of Gastroenterology|
In addition, it had a good readability compared to older tests.
Also, 3 immunochemical tests had acceptable performance characteristics and were easy to use, though were expensive.
Immudia Hem Sp is the only immunochemical test commercially available.
Dr Graeme Young's team concluded that, "At present, there is no extensively studied FOBT that fulfills the needs for all target populations worldwide".
They considered that, "The more sensitive newer tests should be used if dietary compliance is good [in the case of guaiac tests] and if colonoscopy resources are adequate for diagnosis of any patients who test positive".
"Immunochemical tests remove the difficulties created by diet and drug restrictions and are more amenable to standardized development and quality control", they conclude.