title: Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test.
abstract: OBJECTIVE
  To compare the uptake of faecal immunochemical occult blood test (FIT) with guaiac faecal occult blood test (gFOBT) in a screening programme, with specific attention to the demographic and socioeconomic factors that might affect test uptake.
  
  
  METHODS
  The Clalit Health Service screening programme, Israel.
  
  
  METHODS
  Average-risk individuals aged 50-75 years were randomized into a FIT arm or gFOBT arm using a programme based on the socioeconomic status (SES) of their primary care clinics. G-FOBT was performed with Hemoccult SENSA™ (3 evacuations) and FIT with the OC- MICRO(TM) (3 evacuations, refrigerating mandated). The GLIMMIX model was used.
  
  
  RESULTS
  There were 5,464 and 10,668 eligible participants in the FIT and gFOBT arms respectively. Compliance in taking the kits was better (but not statistically significantly better) with gFOBT (37.8% vs. 29.3%; odds ratio [OR] 1.43 [95% CI 0.73-2.80]; P = 0.227). Kit return was higher in the FIT arm (65.0% vs. 78.9%; OR 0.45 [95% CI 0.24-0.83], P = 0.021). Overall test uptake was affected by age, gender, being immigrant and SES (determined by whether or not the participant paid national insurance tax, and the SES of the primary care clinic). The overall uptake of gFOBT and FIT was comparable (OR 0.996 [95% CI 0.46-2.17], P = 0.99).
  
  
  CONCLUSIONS
  Overall compliance for test uptake was comparable between the two methods despite the more demanding procedure in the FIT arm. Sociodemographic parameters were the major determinants of compliance. An educational programme, with emphasis on the sociodemographic characteristics of the target population, should be instigated.
authors: The Gastroenterology Unit, Clalit Health Services, Tel Aviv, Israel.
authors: Shlomo
authors: S
authors: Birkenfeld
authors: Rachel Gingold
authors: RG
authors: Belfer
authors: Miri
authors: M
authors: Chared
authors: Alex
authors: A
authors: Vilkin
authors: Micha
authors: M
authors: Barchana
authors: Irena
authors: I
authors: Lifshitz
authors: Dana
authors: D
authors: Fruchter
authors: Dina
authors: D
authors: Aronski
authors: Ran
authors: R
authors: Balicer
authors: Yaron
authors: Y
authors: Niv
authors: Zohar
authors: Z
authors: Levi
mesh_terms: D000368:Aged; D000465:Algorithms; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D015984:Causality; D016000:Cluster Analysis; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007120:Immunochemistry / Q000379:methods* / Q000706:statistics & numerical data; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data*