Guaiac-Based vs. Immunochemical Fecal Occult Blood Testing for Screening

The number of colonoscopies needed to detect one person with advanced neoplasia was 5.1 for guaiac-positive patients but only 2.7 for immunochemical-test–positive patients.

Guidelines on colorectal cancer screening generally include fecal occult blood testing (FOBT) as one of several options (JW Gen Med Oct 28 2008 and Gastroenterology 2008; 134:1570). In this study from Korea, researchers compared a guaiac-based test (Hemoccult II) and a quantitative immunochemical test (OC-Sensa Micro) in 770 average-risk people (age range, 50–75) who then underwent screening colonoscopy. Both FOBTs were performed on three consecutive bowel movements.

Colonoscopy revealed advanced colorectal neoplasia (advanced adenoma or cancer) in 72 patients (9%). The sensitivity of immunochemical testing for advanced neoplasia, at a 100 mg/dL cutoff for positivity, was significantly higher than that of the guaiac-based test (44% vs. 17%),…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose