Stool testing is a widely accepted, non-invasive, technique for colorectal cancer (CRC) screening. Guaiac-based faecal occult blood test (gFOBT) screening has been proven to decrease CRC-related mortality; however gFOBT is hampered by a low sensitivity. Faecal immunochemical tests (FITs) have several advantages over gFOBT. First of all, FIT has a better sensitivity and higher uptake. Furthermore, the quantitative variant of the FIT allows choices on cut-off level for test-positivity according to colonoscopy resources available, personal risk profile, and/or intended detection rate in the screened population. Stool-based DNA (sDNA) tests aiming at the detection of specific DNA alterations may improve detection of CRC and adenomas compared to gFOBT screening, but large-scale population based studies are lacking. This review focuses on factors influencing test performance of those three stool based screening tests.

Adenomas, Colorectal cancer, FIT, FOBT, Faecal DNA test, Faecal immunochemical test, Guaiac-based faecal occult blood test, Performance, Screening,
Best Practice and Research in Clinical Gastroenterology
Erasmus MC: University Medical Center Rotterdam

van Dam, L, Kuipers, E.J, & van Leerdam, M.E. (2010). Performance improvements of stool-based screening tests. Best Practice and Research in Clinical Gastroenterology (Vol. 24, pp. 479–492). doi:10.1016/j.bpg.2010.03.009