Improved Stool-Based Test Could Boost Colon Cancer Screening

It's more accurate, and patients don't need to change diet beforehand

TUESDAY, Feb. 20, 2007 (HealthDay News) -- More convenient and less invasive tests are needed in order to increase colorectal cancer screening rates in the United States, researchers say, and a type of fecal sampling test may be ideal.

The fecal sampling test, called I-FOBT, was approved by the U.S. Food and Drug Administration in 2001, but is used infrequently by doctors, said Dr. Thomas Imperiale, a professor of medicine in the Indiana University School of Medicine. His editorial on the subject is published in the Feb. 20 issue of the journal Annals of Internal Medicine.

"In recent years, use of non-invasive screening has declined in favor of colonoscopy, but not everyone is willing to have a colonoscopy," Imperiale wrote.

"The new immunochemical fecal occult blood test, referred to as I-FOBT, is a significant improvement over the older guaiac-based version," he said. "The newer fecal test has the potential to substantially increase screening rates for colorectal cancer, taking us back to the future in a sense."

I-FOBT uses antibodies to detect human blood in stool. Older fecal sampling tests can't differentiate between blood from the digestive tract and blood from the diet.

The superior detection ability of I-FOBT eliminates the need for people to go on a restricted diet before colon cancer screening, which may encourage more people to get screened.

I-FOBT enables doctors to select different thresholds to indicate a positive result, which means the test can be used to check people with any level of risk for colorectal cancer.

"The test output (amount of hemoglobin per gram of stool) is a continuous variable, which means that a clinician can choose an I-FOBT positivity threshold to suit the patient's clinical characteristics, such as age, and reduce the chance of false-positive test results," Imperiale wrote.

In the United States, colorectal cancer is the third most common kind of cancer and the third leading cause of cancer death. More than 52,000 Americans will die of colorectal cancer in 2007, according to the U.S. National Cancer Institute.

More information

The U.S. National Cancer Institute has more about colorectal cancer screening.

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