gFOBTGuaiac Fecal-Occult Blood Test
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gFOBT and FIT have advantages such as being convenient, inexpensive (US 1 dollar and US 10 dollar), and quick (30 min), but their results are instable (sensitivity: gFOBT 6.2-83.3%, FIT 5.4-98.0% and specificity: gFOBT 80.0-98.4%, FIT 77.0- 99.0%).
Positive gFOBT results were also associated with other disease-specific mortality outcomes, including circulatory, respiratory, and digestive disease.
(31) Annual screening using gFOBT, which detects the presence of the heme portion of human hemoglobulin in stool, (32,33) is convenient because 3 stool samples can be collected at home without bowel preparation prior to sample collection.
There was also a significant correlation for f-Hb detectable by gFOBT with increased risk of dying from circulatory disease, respiratory disease, digestive diseases (excluding CRC), neuropsychological disease, blood and endocrine disease, and non-CRCs.
Uptake of the BCSP is a major public health concern with only 59% of eligible invitees completing and returning a gFOBt [6].
(5) The FITs have been shown to have better analytic sensitivity and specificity than gFOBT has, as well as better clinical sensitivity, with minimal loss of clinical specificity.
We have recently shown the coexistence of inappropriate under- and overutilization of colonoscopy in Ontario, for example, suboptimal rates of colonoscopic follow-up of positive gFOBT among participants in the provincial colorectal screening program [3] and high rates of repeat colonoscopy less than five years after complete negative colonoscopy [4].
The gFOBT detects the presence of blood in stools, and indicator cancer may be present whereas the new FIT test measures the amount of blood, making it more accurate.
In this study we proposed gFOBT instead of FIT as a tool for CRC screening, because it's cheaper and more available in primary laboratories in Iran, particularly in small cities.
Stool-based screening, which includes an annual guaiac-based fecal occult blood test (gFOBT) and fecal immunochemical test (FIT), can be done at home over several days.
As with gFOBT, annual testing is recommended, and a positive test must be followed by colonoscopy.
This stool-screening option is more specific for human blood and lower GI bleeding than is gFOBT because it tests for human globin and not just heme.