TABLE 11.
Recommendations for use of fecal immunochemical tests (FIT) in organized colorectal cancer screening programs
| Guideline document/author (reference), year | Recommendations |
|---|---|
| Levin et al (27), 2008 | Annual testing with either gFOBT or FIT in both male and female participants 50 years of age or older are both acceptable options for colorectal cancer screening. |
| Centre for Evidence-Based Practice in the NHS (24), 2009 | Compared: Hem-SP/MagStream HT*, OC-Sensor†, FOB, Gold/SENTiFOB‡, FOB Gold DEVEL-A-TAB‡ OC-Sensor DIANA analyzer, despite not being an ideal test, most suitable for the English Bowel Cancer Screening Program. |
| Health Council of The Netherlands (26), 2009 | Nationwide screening program using FIT for 55- to 74-year-olds biennially 50 ng/mL is the optimum cut-off level in hemoglobin concentration in terms of cost-effectiveness. Provisionally recommend cut-off level in hemoglobin concentration of 75 ng/mL due to colonoscopy capacity. Single sampling method advised to maximize positivity Samples should be tested as soon as possible once returned to the laboratory. |
| Rex et al (28), 2009 | Annual FIT testing is the preferred colorectal cancer screening method compared with gFOBT. |
| European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis (25), 2010 | FIT is preferred over gFOBT for population screening for colorectal cancer. FIT factors such as ease of use, transportability, sample reproducibility, and sample stability need to be considered when developing a program. Prior to implementation, a pilot study should be performed to ensure that the FIT program chosen achieves a positivity rate that is clinically acceptable, logistically and financially possible. The acceptable loss of completed tests is less than 3% of all tests, with the goal being less than 1% Subject IDs should be easily identifiable, possibly through the use of barcodes. Screening programs should adopt manufacturer’s storage conditions. A local pilot study of FIT should be conducted before widespread implementation. |
*
Fujirebio Inc, Japan and Fujirebio Diagnostics Inc, USA;
†
Eiken Chemical Company Ltd, Japan;
‡
Sentinel Diagnostics, Italy; gFOBT Guaiac fecal occult blood test; ID Identification; NHS National Health Service