Performance improvements of stool-based screening tests

Best Pract Res Clin Gastroenterol. 2010 Aug;24(4):479-92. doi: 10.1016/j.bpg.2010.03.009.


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.

Publication types

  • Review

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • DNA / analysis*
  • Early Detection of Cancer / methods*
  • Feces / chemistry*
  • Guaiac
  • Humans
  • Immunochemistry
  • Indicators and Reagents
  • Molecular Diagnostic Techniques*
  • Occult Blood*
  • Quality Improvement*
  • Sensitivity and Specificity


  • Indicators and Reagents
  • Guaiac
  • DNA