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|
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."