Immunochemical fecal occult blood test in a screening program for colorectal cancer

The Health Council of the Netherlands advised on a national screening program for colorectal cancer (CRC) in November last year. Studies have already shown that screening for CRC using the guaiac based fecal occult blood test (gFOBT) reduces mortality, and more recently, results have been published using the immunological FOBT (iFOBT). The gFOBT and iFOBT do not differ in their CRC-detection rate, however, more advanced adenomas are found using the iFOBT. While the iFOBT is a quantitative test, it offers the possibility of choosing different cut-off points. It appears that, both clinical and analytical, a cut-off point of 75 ng/ml can be used, if adequate capacity for colonoscopy is available.