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Diagnosis of colorectal cancer: FIT-Test - Fecal immuno-chemical test = test on stool is much more sensitive, more reliable (100%), but blood tests for early detection of cancer. Article posted in November 2006.

November 17, 2006: Source: Cancer. 2006, 107:2152-2159 and Medscape

A stool test that looks at immune responses is significantly more effective and reliable than a stool test that looks for blood traces. Both tests can be done at home but now it appears that the FIT test is better than the GFOBT test. Here are the results from the study

The FIT test gave a much more true-positive cancer (n = 24, 87.5% vs 54.2%) and adenomas (n = 61, 42.6% vs 23.0%).

Wrong-positive for any kind of a deviation (neoplasia) was slightly higher with the FIT test with the GFOBT (3.4% vs 2.5%, 95% confidence interval of difference, 0% - 1.8%), whereas positive predictive values were 41.9 % and 40.4% for the FIT for GFOBT.

Fecal Immuno Chemical Test May Be Most Effective for At-Home Colon Cancer Screening CME News Author: Laurie Barclay, MD

November 1915, 2006 ¡ª The fecal immuno chemical test is more effective for at-home colon cancer screening is now a sensitive fecal occult blood test (FOBT), According To Reported the results of a study in the November issue of Cancer.

"Fecal immuno-chemical tests (FIT) are an advanced fecal occult blood test (FOBT) Technology that Reduces barriers to population screening by Simplifying the logistics of stool-sampling," write Alicia Smith, MD, of the Repatriation General Hospital, Daw Park, South Australia, and colleagues. "The current study was Conducted to under take a paired comparison of a sensitive Guaiac FOBT (GFOBT, Hemoccult II Sensa, Beckman Coulter, Fullerton, CA) with a brush-sampling FIT (Insure, Enterix, North Ryde, NSW, Australia), to determining whethere this FIT improves detection of significant neoplasia. "

While following Dietary Restrictions for GFOBT 'appropriate, a screening cohort of 2351 adults and a group of 161 patients diagnosed Symptomatic sampled Consecutive stools at home, and GFOBT Using FIT Both sampling devices. The investigators paired comparison of positivity rates Performed In Those found to have cancer and / or significant adenoma (high-grade dysplasia, villous change, ¡Ý 10 mm, serrated Histology, or ¡Ý 3 polyps), benign pathology, or no pathology.

Based on combined results for Both cohorts, the FIT gift a true-positive result significantly more Often in cancer (n = 24, 87.5% vs 54.2%) and in significant adenomas (n = 61, 42.6% vs 23.0%). Of all 13 patients with UICC (International Union Against Cancer) stage I cancers, 12 had a positive FIT and 4 had a positive result GFOBT (P = .002).

Analyses of the screening cohort alone revealed thats the FIT was superior to the GFOBT for detecting cancers and significant adenomas. The false-positive rate for neoplasia was marginally Any Higher Than the GFOBT with the FIT (3.4% vs 2.5%, 95% confidence interval of difference, 0% - 1.8%), whereas positive predictive values for the FIT Were 41.9% and 40.4 % for the GFOBT.

"This brush-sampling FIT is more sensitive for cancers and significant adenomas GFOBT Than a sensitive," the authors write. "As such, it Should Deliver Greater Reduction in colorectal cancer mortality and incidence Than the GFOBT."

Study Limitations include inability to directly estimate specificity for neoplasia or pathology or Any type. "Although this study Has Been Directed Toward Examining relative effectiveness for detection of neoplasia, the FIT technology Also HAS distinct behavioral Advantages," the authors conclude the. "Patients are more Likely to Participate, ie, complete and return the test sampling kit, When diet and drug Restrictions are removed When A Simpler and sampling procedure, Such As the brush method combined with Reduced number of samples is Used. As detection or neoplasia at the population level is a product of sensitivity and participation, brush-sampling FIT Will Achieve Better Than detection GFOBT spatula-sampling. "

The National Health and Medical Research Council of Australia and Enterix Australia Pty.. Ltd. funded this study.

Cancer. 2006, 107:2152-2159.