title: Performance improvements of stool-based screening tests.
abstract: Stool testing is a widely accepted, non-invasive, technique for colorectal cancer (CRC) screening. Guaiac-based faecal occult blood test (gFOBT) screening has been proven to decrease CRC-related mortality; however gFOBT is hampered by a low sensitivity. Faecal immunochemical tests (FITs) have several advantages over gFOBT. First of all, FIT has a better sensitivity and higher uptake. Furthermore, the quantitative variant of the FIT allows choices on cut-off level for test-positivity according to colonoscopy resources available, personal risk profile, and/or intended detection rate in the screened population. Stool-based DNA (sDNA) tests aiming at the detection of specific DNA alterations may improve detection of CRC and adenomas compared to gFOBT screening, but large-scale population based studies are lacking. This review focuses on factors influencing test performance of those three stool based screening tests.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Netherlands. l.vandam.1@erasmusmc.nl
authors.forename: Leonie
authors.initials: L
authors.lastname: van Dam
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Monique E
authors.initials: ME
authors.lastname: van Leerdam
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004247:DNA / Q000032:analysis*; D055088:Early Detection of Cancer / Q000379:methods*; D005243:Feces / Q000737:chemistry*; D006138:Guaiac; D006801:Humans; D007120:Immunochemistry; D007202:Indicators and Reagents; D025202:Molecular Diagnostic Techniques; D009780:Occult Blood; D058996:Quality Improvement; D012680:Sensitivity and Specificity
chemical_list: D007202:Indicators and Reagents; D006138:Guaiac; D004247:DNA