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Several recent colon cancer screening guidelines have recommended replacing any older low-sensitivity, guaiac-based fecal occult blood testing (gFOBT) with either newer high-sensitivity guaiac-based fecal occult blood testing (gFOBT) or fecal immunochemical testing (FIT), which tests for globin rather than the heme detected by the guaiac method.
The fecal immunochemical test (FIT) is a diagnostic technique that examines stool samples for traces of non-visible blood, which could potentially indicate conditions including bowel cancer. [1] Symptoms which could be caused by bowel cancer and suggest a FIT include a change in bowel habit, anaemia, unexplained weight loss, and abdominal pain.
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).
The American College of Gastroenterology has recommended the abandoning of gFOBT testing as a colorectal cancer screening tool, in favor of the fecal immunochemical test (FIT). [3] The newer and recommended tests look for globin, DNA, or other blood factors including transferrin, while conventional stool guaiac tests look for heme.
The consequences of overdiagnosis and overtreatment resulting from cancer screening can lead to a decline in quality of life, due to the adverse effects of unnecessary medication and hospitalization. [10] [12] [13] The accuracy of a cancer screening test relies on its sensitivity, and low sensitivity screening tests can overlook cancers. [10]
The American Cancer Society issues recommendations on colorectal cancer screening guidelines. These guidelines often change and are updated as new studies and technologies have become available [ 9 ] Many other national organizations also issue such guidance, such as the UK's NHS [ 36 ] and various European agencies, [ 37 ] guidance can vary ...
The signs and symptoms of colorectal cancer depend on the location of the tumor in the bowel, and whether it has spread elsewhere in the body ().The classic warning signs include: worsening constipation, blood in the stool, decrease in stool caliber (thickness), loss of appetite, loss of weight, and nausea or vomiting in someone over 50 years old. [15]
In 1997, the National Cancer Institute published a set of recommendations called the Bethesda guidelines for the identification of individuals who should receive genetic testing for Lynch syndrome related tumors. [6] The NCI revisited and revised these criteria in 2004. [7] The Revised Bethesda Guidelines are as follows:
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