“Quantitative FIT is the first choice test for population-wide screening”*
(*from Karsa L. et al. Overview: European guidelines for quality assurance in CRC screening and diagnosis… Endoscopy 2013; 45: 51-59
Faecal Immunochemical Tests (FIT) are able to detect and quantify, with the aid of specific antibodies, the presence of human haemoglobin in a stool sample. Thereby, allowing you to distinguish between quantitative and qualitative FIT.
Quantitative FIT tests offer an automated, quality-assured and precise evaluation under standardised conditions in a medical laboratory. Interpretation is objective and thereby rules out misinterpretations.
The “European Guidelines for Quality Assurance in Colorectal Cancer Screening” recommend quantitative FIT as the first choice for population-wide early detection of colorectal cancer because:
- FIT offers greater sensitivity and specificity than gFOBT
- Quantitative FIT tests are automated: for optimum standardisation/quality assurance
- In the case of quantitative FIT the cut-off score (borderline score) can be adjusted
Analysis of rapid qualitative tests can be performed in the laboratory of the GP practice. However, the visual interpretation of results by a colour change reaction is subjective and prone to false positive reporting. There are a multitude of tests on market that vary greatly in their sensitivity, specificity and limit of detection.
Qualitative FIT tests deliver a qualitative “Yes/No” result relating to a borderline score, which is set by the respective test manufacturer, is difficult to verify. This fixed cut off makes them impossible to adapt to local requirements and therefore not suitable for national screening program use.