FIT to be tried

Abstract

Colorectal cancer (CRC) screening has come of age in Canada, with every province now having a screening program either implemented or well underway. These programs are based on the detection of fecal occult blood, with positive results triggering colonoscopy for definitive diagnosis. This approach is supported by high-level evidence demonstrating a mortality benefit for individuals screened in this manner. Fecal occult blood testing (FOBT) uses indirect methods to test for the presence of hemoglobin, which can be affected by chemicals, such as vitamin C, or heme from other sources such as red meat. In contrast, fecal immunochemical tests (FIT) use an antibody to detect human globin directly. These assays may offer advantages of greater specificity and sensitivity, and improved adherence. Most FITs produce a visual colour change on a strip to indicate a positive result, but some are analyzed using automated systems in a laboratory to provide a quantitative result.