+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The immunochemical faecal occult blood test leads to higher compliance than the guaiac for colorectal cancer screening programmes: a cluster randomized controlled trial



The immunochemical faecal occult blood test leads to higher compliance than the guaiac for colorectal cancer screening programmes: a cluster randomized controlled trial



Journal of Medical Screening 12(2): 83-88



We conducted a cluster-randomized trial aimed at assessing the effect of the type of faecal occult blood, guaiac or immunochemical test on screening compliance. We sampled 130 general practitioners (GPs) who consented to participate in the trial. We randomly allocated half of them to the guaiac (Hemo-Fec) and half to the immunochemical test (OC-Hemodia). We sampled 2/10 of the GPs' 50-75-year-old patients (n=7332) and randomly divided this population into half. One half was invited to be screened at the GP's office and the other to the nearest gastroenterology ward. The principal outcome was the percentage of returned tests. The immunochemical test had a compliance of 35.8% and the guaiac of 30.4% (relative risk [RR] 1.20; 95% confidence interval [CI] 1.02-1.44). The difference was mostly due to a higher probability of returning the sample: 93.8% and 88.6% for immunochemical and guaiac, respectively (RR 1.06; 95% CI 1.02-1.10). The guaiac test had a higher prevalence of positives (10.3% versus 6.3%, RR 0.603; 95% CI 0.433-0.837). There was a higher variability in the results obtained with the guaiac test compared with the immunochemical (F[1, 12] = 16.25; P=0.0017). Compliance is more likely with the immunochemical than the guaiac test, independent of the provider. Guaiac tests show a higher variability of the results among centres. The successful implementation of a screening programme requires a period of standardization of the test reading in order to avoid unexpected work overload for colonoscopy services.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 050648062

Download citation: RISBibTeXText

PMID: 15949119

DOI: 10.1258/0969141053908357


Related references

Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test. Journal of Medical Screening 18(3): 135-141, 2011

A higher detection rate for colorectal cancer and advanced adenomatous polyp for screening with immunochemical fecal occult blood test than guaiac fecal occult blood test, despite lower compliance rate. A prospective, controlled, feasibility study. International Journal of Cancer 128(10): 2415-2424, 2011

Screening for colorectal cancer: comparison of perceived test burden of guaiac-based faecal occult blood test, faecal immunochemical test and flexible sigmoidoscopy. European Journal of Cancer 46(11): 2059-2066, 2010

Colorectal cancer screening adherence is higher with fecal immunochemical tests than guaiac-based fecal occult blood tests: a randomized, controlled trial. Preventive Medicine 50(5-6): 297-299, 2010

A sensitive guaiac faecal occult blood test is less useful than an immunochemical test for colorectal cancer screening in a Chinese population. Alimentary Pharmacology & Therapeutics 18(9): 941-946, 2003

Guaiac versus immunochemical tests: faecal occult blood test screening for colorectal cancer in a rural community. Australian and new Zealand Journal of Public Health 29(4): 358-364, 2005

Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut 59(1): 62-68, 2010

Comparison of a guaiac based and an immunochemical faecal occult blood test in screening for colorectal cancer in a general average risk population. Gut 56(2): 210-214, 2007

Immunochemical testing of individuals positive for guaiac faecal occult blood test in a screening programme for colorectal cancer: an observational study. Lancet. Oncology 7(2): 127-131, 2006

Is the type of test used for mass colorectal cancer screening a determinant of compliance? A cluster-randomized controlled trial comparing fecal occult blood testing with flexible sigmoidoscopy. Cancer Detection and Prevention 30(4): 347-353, 2006

Self-administered faecal occult blood tests do not increase compliance with screening for colorectal cancer: results of a randomized controlled trial. European Journal of Cancer Prevention 2(4): 301-305, 1993

M1013 a Cost-Effectiveness Analysis in Colorectal Cancer Screening Comparing Immunochemical Faecal Occult Blood Tests with Guaiac Faecal Occult Blood Tests and No Screening. Gastroenterology 136(5): A-331, 2009

Evaluation and comparison of an immunochemical and a guaiac faecal occult blood screening test for colorectal neoplasia. European Journal of Cancer Prevention 4(6): 475-481, 1995

Guaiac and immunochemical tests for faecal occult blood in colorectal cancer screening. British Journal of Cancer 65(6): 942-944, 1992

Cost-effectiveness of colorectal cancer screening programmes using sigmoidoscopy and immunochemical faecal occult blood test. Journal of Medical Screening 26(2): 76-83, 2019