Randomized Comparison of Guaiac-Based vs. Immunochemical FOBT

The Joint Colorectal Cancer Screening Guideline recommends that fecal occult blood testing (FOBT) be performed using immunochemical methods rather than guaiac-based methods (JW Gastroenterol Apr 4 2008). However, direct comparisons between the two test types have been performed only in patients at high risk for, or previously diagnosed with, colorectal cancer (CRC).

Now, investigators have prospectively compared the performance of guaiac-based FOBT (Hemoccult II) and immunochemical FOBT (OC-Sensor) in a general screening population. A random sample of 20,623 older Dutch adults (age range, 50–75) underwent CRC screening with one of the two types of tests. A standard cutoff of 100 ng/mL was used for immunochemical FOBT. Positive results on eit…