Professional Documents
Culture Documents
ON:
Fecal Immunochemical Test versus
Guaiacs Test in Colorectal Cancer
Screening
In partial requirement of the Requirement for the
Degree of Bachelor of Science in Medical Technology
Presented by:
ARCIAGA, FRANCES GELINE R
.
Presented to:
DEAN CESAR M. MENDOZA, JR.
identification
of
well-defined
pre-malignant
lesion,
the
adenomatous polyp, together with the good survival associated with early
disease, make colorectal cancer an ideal target for screening. In the past
quarter of a century, great progress has been made in our ability to screen
patients for colorectal cancer or its precursor state, using advances in
imaging and diagnostic technology. Winawer (2001) noted that Greegor
(1967) had first employed the faecal occult blood guaiac test cards, that the
flexible sigmoidoscope was introduced in the mid-1970s to replace the rigid
sigmoidoscope that had been first introduced in 1870 and that colonscopy
has been available since 1970 (Winawer, SJ. 1997).
According to Levin (2008), recommended strategies for colorectalcancer screening fall into two broad categories: stool tests (occult blood and
and
prevention
of
colorectal
cancer.
Although
data
from
applying when comparing different FITs. The studies have shown that the
semiquantitative FIT is more accurate than the guaiac test for the detection
of colorectal cancer and advanced adenomas (Dancourt, V. et.al 2008) and
this new test is now recommended as the first-choice fecal occult blood test
in colorectal-cancer screening. Although FIT is less effective for neoplastic
detection than colonoscopy or sigmoidoscopy, evidence suggests that it may
be better accepted (Hol, L. et.al 2010) and higher acceptance may
counteract its lower detection capacity. It has been suggested that FIT may
be more effective and less costly than other screening strategies. (Segnan, S.
2007)
Higher sensitivities are achievable for CRC with FIT than gFOBT. For
example, one test with a positivity threshold of 20 g Hb/g feces as cutoff
has been reported to have a sensitivity for cancer of 87.192.3 % compared
with 30.874.2 % for a traditional gFOBT (Oort FA, et.al 2010) (Park DI, et.al
2010) In addition to offering higher sensitivity, the immunochemical tests
may be more acceptable to patients because they do not require dietary
restriction and the sample collection methods for some of the tests are
designed to be more user-friendly, requiring fewer samples or less direct
handling of stool. (Cole, SR. 2003)
Test positivity rate in a general screening population tends to be higher
with FIT compared with gFOBT. One comparison using a FIT at a positivity
threshold of 20 g Hb/g feces (and collection of 1 sample), the positivity rate
for the FIT was 3.45.5 % compared with 2.43.5 % for the gFOBT. (Fraser
CG, et.al 2012) (Chubak J, et.al 2012) (van Rossum LG, et.al 2008)
FITs are more sensitive for advanced adenomas than gFOBT and so
improve capacity to prevent cancer. Several studies show that FIT has a
sensitivity for advanced adenoma 23 times that of gFOBT although this is
dependent on the chosen cutoff concentration (Brenner, H., et.al 2013) (Oort
FA, et.al 2010) (Park DI, et.al 2010)
and
cost-effectiveness.
In
conclusion,
including
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and immunochemical fecal occult blood tests for colorectal cancer in a
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Marion R. Nadel, Zahava Berkowitz, Carrie N. Klabunde, Robert A. Smith,
Steven S. Coughlin, Mary C. White Fecal Occult Blood Testing Beliefs and
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Levy BT, Bay C, Xu Y, Daly JM, Bergus G, Dunkelberg J, Moss C. Test
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Stephen Ip, AbdulRazaq AH Sokoro, Lisa Kaita, Claudia Ruiz, Elaine McIntyre,
Harminder Singh Use of fecal occult blood testing in hospitalized patients:
Results of an audit Can J Gastroenterol Hepatol. 2014 Oct; 28(9): 489494.
Boyle P. Faecal occult blood testing (FOBT) as screening for colorectal cancer:
the current controversy. Ann Oncol2002; 13: 1618.
Graeme P. Young, Erin L. Symonds, James E. Allison, Stephen R. Cole, Callum
G. Fraser, Stephen P. Halloran, Ernst J. Kuipers, Helen E. Seaman Advances in
Fecal Occult Blood Tests: The FIT Revolution
Dig Dis Sci. 2015; 60(3): 609622.