Colorectal cancer screening adherence is higher with fecal immunochemical tests than guaiac-based fecal occult blood tests: a randomized, controlled trial

Prev Med. May-Jun 2010;50(5-6):297-9. doi: 10.1016/j.ypmed.2010.03.010. Epub 2010 Mar 20.


Objectives: Determine whether colorectal cancer screening adherence is greater with fecal immunochemical tests (FIT) or guaiac-based fecal occult blood tests (gFOBT).

Methods: We used electronic health records to identify 3869 New Mexico Veterans Affairs Health Care System primary care patients due for screening in 2008 for whom fecal blood testing was appropriate. We invited randomly selected patients by mail to participate in a study comparing FIT and gFOBT. We randomly allocated 404 subjects to receive FIT (n=202) or gFOBT (n=202) by mail. We determined the proportion of subjects completing testing within 90days of agreeing to participate in the study. We also used multivariate logistic regression to evaluate screening completion, adjusting for age, gender, race/ethnicity, clinic site, previous gFOBT testing, and co-morbidity.

Results: Screening adherence was higher with FIT than gFOBT (61.4% vs. 50.5%, P=0.03). The adjusted odds ratio for completing FIT vs. gFOBT was 1.56, 95% CI 1.04, 2.32.

Conclusion: In a clinic setting of patients who were due for colorectal cancer screening, adherence was significantly higher with FIT than gFOBT.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Chi-Square Distribution
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / diagnosis*
  • Electronic Health Records
  • Feces
  • Female
  • Guaiac
  • Humans
  • Immunochemistry* / methods
  • Immunochemistry* / statistics & numerical data
  • Indicators and Reagents
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • New Mexico
  • Occult Blood*
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Patient Satisfaction / statistics & numerical data
  • Primary Health Care
  • Reagent Kits, Diagnostic
  • Statistics, Nonparametric
  • Veterans / psychology
  • Veterans / statistics & numerical data


  • Indicators and Reagents
  • Reagent Kits, Diagnostic
  • Guaiac