In a large population-based screening study, the OC Sensor (Polymedco) test was superior to the Magstream test.
Experts widely agree that a fecal immunochemical test (FIT) should replace a guaiac-based fecal occult blood test for colorectal cancer (CRC) screening because of its higher adherence rates and superior performance characteristics. However, the performance characteristics of different FITs have been shown to vary dramatically (Ann Intern Med 2009; 150:162). Therefore, the clinical issue has not been whether to use a FIT, but which FIT to use. In the current study, investigators compared the OC Sensor FIT (Eiken Chemical Co., Tokyo, Japan), commonly studied in clinical trials, to the Magstream FIT (Fujirebio, Inc., Tokyo, Japan), and the Hemoccult II guaiac test (SKD, Villepinte, France).
Researchers analyzed fecal samples from 19,797 residents of 2 French counties who had participated in a CRC screening study. Participants were aged 50 to 74 years and asymptomatic, had no personal history of CRC or advanced adenoma, and had not received a colonoscopy in the past 5 years. Two of 3 sections of consecutive stools were sampled for Hemoccult II, and two samples were checked with both the OC Sensor and the Magstream. Patients underwent colonoscopy if any tests were positive.
Of 1224 patients who were positive for at least 1 test, 1075 underwent colonoscopy, at which 334 patients had CRC or advanced adenoma identified. The numbers needed to scope and to screen were lower for the FIT tests than for the guaiac test, and the FITs detected more advanced neoplasms. OC Sensor had a lower number needed to screen to detect 1 advanced neoplasm using 1 sample compared with Magstream (88 vs. 136). OC Sensor detected more cancers and advanced neoplasms than Magstream using 1 or 2 samples, using the manufacturer cut-off, using a cut-off established in the study, and after adjusting the rates of positivity.
CITATION(S):
Raginel T et al. A population-based comparison of immunochemical fecal occult blood tests for colorectal cancer screening. Gastroenterology 2013 May; 144:918.
