What Is the Best Cutoff Value for a Fecal Immunochemical Test?

On the basis of cost-effectiveness simulations using European data, a FIT level of ≥50 ng hemoglobin/mL would trigger a referral for screening colonoscopy.

Current colorectal cancer screening recommendations favor the fecal immunochemical test (FIT) over guaiac-based fecal occult blood testing (gFOBT). The most studied and best established FIT is marketed in the U.S. as the OC Autosensor (Polymedco). This test was used in two randomized controlled trials conducted in the Netherlands that compared FIT to gFOBT (Br J Cancer 2009; 100:1103 and Gastroenterology 2008; 135:82) and found that FIT had a higher participation rate and better test characteristics without additional cost. The manufacturer-recommended level for referral to colonoscopy with this test is 100 ng hemoglobin/mL. Now, Dutch researchers have tested a range of FIT cutoff levels (50, 75, 100, 150, and 200) for cost-effectiveness of…

Reviewing Author

Douglas K. Rex, MD

Disclosures

Consultant/Advisory BoardOlympus Corporation America; Boston Scientific

Speaker’s BureauOlympus

Grant/Research SupportMedtronic; Boston Scientific; Colonary Solutions; Paion Medical; Medivators; Braintree Laboratories

Editorial BoardsWorld Journal of Gastroenterology; The Journal of Clinical Gastroenterology; Techniques in Gastrointestinal Endoscopy; Gastroenterology & Hepatology; Expert Review of Gastroenterology & Hepatology; Medscape Gastroenterology; World Journal of Gastrointestinal Pharmacology and Therapeutics; Annals of Gastroenterology & Hepatology; World Journal of Gastrointestinal Oncology; Comparative Effectiveness Research; Journal of Anesthesia & Clinical Research; Gastroenterology; World Journal of Gastrointestinal Pathophysiology; Gastroenterology Research and Practice; GI & Hepatology News; Gastroenterology Report; Clinical Epidemiology Reviews; JSM Gastroenterology and Hepatology; GI Journal Watch; Austin Journal of Gastroenterology; World Journal of Gastrointestinal Pharmacology & Therapeutics

Leadership Positions in Professional SocietiesAmerican Society for Gastrointestinal Endoscopy (Treasurer); US Multi-Society Task Force (AGA, ACG, ASGE) (Chair)

Douglas K. Rex, MD

Disclosures

Consultant/Advisory BoardOlympus Corporation America; Boston Scientific

Speaker’s BureauOlympus

Grant/Research SupportMedtronic; Boston Scientific; Colonary Solutions; Paion Medical; Medivators; Braintree Laboratories

Leadership Positions in Professional SocietiesAmerican Society for Gastrointestinal Endoscopy (Treasurer); US Multi-Society Task Force (AGA, ACG, ASGE) (Chair)