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There are no clear differences in sensitivity between FIT and the newer high-sensitive gFOBT.
The gFOBT detects the peroxidase activity of heine in blood and other peroxidases in stool (Cole, Young, Esterman, Cadd, & Morcom, 2003), while the iFOBT detects human hemoglobin's intact globin protein (Levin et al.
The iFOBT and stool DNA tests are relatively new technology, while the gFOBT was first described in 1864, developed in 1967, and marketed since 1970.
The gFOBT is the most convenient method because the visual interpretation of color change can be done in-office (Wong et al.
The gFOBT has a long history of use for detecting the presence of blood in the stool and is based on the pseudoperoxidase activity of heme in human hemoglobin.
The FIT or immunochemical fecal occult blood test (iFOBT) is similar to the gFOBT in that it detects blood, except that it directly detects the human globin portion of hemoglobin.
Digital rectal exam by itself is not considered a screen for CRC either with or without a gFOBT or FIT performed on fecal material collected at that time.
6] Nonstandard abbreviations: POCT, point-of-care test; FIT, fecal immunochemical test for hemoglobin; gFOBT, guaiac-based fecal occult blood test; PLM, professional in laboratory medicine; STARD, Standards for Reporting of Diagnostic Accuracy.
As the authors mention, FITs are rapidly superseding traditional gFOBTs because of their many advantages, including that only a single sample is generally collected, the available collection devices encourage adoption of the test, the test is more specific for lower gastrointestinal bleeding, and dietary restriction is definitely not required.
27) The fecal immunochemical test (FIT), a variation of the FOBT, recognizes the protein (globin) portion of the hemoglobin molecule and was developed to address the concern of low sensitivity with gFOBT tests that recognize only the heme.
Evidence that gFOBT screening reduces CRC mortality was reported in a systematic review of 4 randomized controlled trials.
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