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Clin Biochem. 2008 Nov;41(16-17):1289-305. doi: 10.1016/j.clinbiochem.2008.08.069. Epub 2008 Aug 29.

Cancer Care Ontario guaiac fecal occult blood test (FOBT) laboratory standards: evidentiary base and recommendations.

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  • 1Department of Medicine, University of Toronto, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave T2-025, Toronto, ON, Canada M4N3M5. linda.rabeneck@sunnybrook.ca

Abstract

OBJECTIVES:

To evaluate the evidence concerning gFOBT kits and to develop gFOBT standards to be implemented by the Ontario Colorectal Cancer (CRC) Screening Program (the "Program").

DESIGN AND METHODS:

We evaluated 3 aspects of gFOBT kits: 1) performance factors; 2) usability factors; and 3) laboratory factors. We obtained information from the published literature, other countries that use gFOBT, the internet, and gFOBT kit manufacturers' instructions.

RESULTS:

The Program should use a single brand of gFOBT kit with sensitivity > or =40% and specificity > or =95% for the detection of CRC in repeated testing. The Program should regularly monitor gFOBT performance. Participants should not restrict their diets except for eliminating vitamin C supplements and citrus fruits and juices for 3 days prior to and during stool collection; participants should not discontinue taking aspirin (ASA) or non-steroidal anti-inflammatory drugs (NSAIDs). The Program should use one or a limited number of labs; leak-proof envelopes should be used that protect samples during mailing; the lab should delay processing fecal samples for at least 48 h following stool collection; the lab should implement staff training and quality control protocols.

CONCLUSIONS:

The Program should monitor and report on its performance according to these standards, and should continually assess new evidence related to CRC screening methods.

PMID:
18796300
[PubMed - indexed for MEDLINE]
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