Comparing participation rates between immunochemical and guaiac faecal occult blood tests: a systematic review and meta-analysis

Prev Med. 2012 Aug;55(2):87-92. doi: 10.1016/j.ypmed.2012.05.006. Epub 2012 May 23.


Background: Biennial screening with faecal occult blood tests (FOBts) has been found to reduce colorectal cancer mortality. Faecal immunochemical tests (FITs) are superior to guaiac faecal occult blood tests (G-FOBts) due to their improved sensitivity and specificity. However the effectiveness of a screening programme depends highly on participation rates. The aim of this study was to review studies comparing guaiac faecal occult blood tests and faecal immunochemical tests, in terms of participation rates.

Methods: We searched PubMed and the Cochrane Library (2000-September 2011) to identify randomised control trials comparing guaiac faecal occult blood test with faecal immunochemical test participation rates. One author screened the titles and abstracts, and performed data extraction which was then checked by the other authors. Risk of bias in the included studies was also assessed.

Results: Seven studies met the eligibility criteria and were entered into a meta-analysis. Participation rates were significantly higher for individuals offered faecal immunochemical tests compared to those offered a guaiac faecal occult blood test (RR 1.21; 95% CI 1.09-1.33). Potential factors that could have influenced participation were discussed.

Conclusions: Colorectal cancer screening programmes currently using guaiac faecal occult blood tests could improve participation rates by converting to faecal immunochemical tests. More research examining the acceptability of faecal immunochemical tests, from a patient perspective, is warranted.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • Guaiac*
  • Humans
  • Immunochemistry
  • Indicators and Reagents*
  • Mass Screening
  • Occult Blood*
  • Patient Participation


  • Indicators and Reagents
  • Guaiac