Immunochemical faecal occult blood (FOB) tests should be the preferred option for bowel cancer screening in pharmacy as they are superior to the older but still available guaiac tests.
Speaking at the Australian Pharmacy Professional (APP) conference on the Gold Coast yesterday, gastroenterologist Dr Cameron Bell said immunochemical tests are more accurate, convenient, and lead to improved compliance with bowel cancer screening.
Dr Bell, who is also a director of Bowel Cancer Australia, said research clearly demonstrates that immunochemical FOB tests are significantly better at detecting bowel cancer than guaiac tests as they are more sensitive and more specific.
“Immunochemical tests, such as those used by BowelScreen Australia® and the National Bowel Cancer Screening Program, are likely to detect nine out on 10 cancers compared to guaiac tests which detect about four out of 10 cancers.”
Dr Bell said the time had come to back the evidence on the comparative value of different screening tests. Screening with an inferior product could lead to missed cases of polyps and bowel cancer.
“Getting more Australians to screen for bowel cancer is the priority. Getting them to use an immunochemical test is the preference,” he added.
Delegates were told that immunochemical tests detect 2.5 times the number of cancers and advanced adenomas than the guaiac tests, without the need for significantly more colonoscopies.
Immunochemical tests also give a true positive result for cancer more often than guaiac (88% vs 54%) and significant polyps (43% vs 23%).
“Immunochemical tests have been shown to be the better test. Their use has been endorsed in guidelines by organisations such as the Gastroenterological Society of Australia (GESA) and in practice by programs such as BowelScreen Australia® and the National Bowel Cancer Screening Program,” said Dr Bell.
Bowel Cancer Australia has recently adopted a Position Statement on Faecal Occult Blood Tests (FOB tests) for bowel cancer screening (March 2012), highlighting immunochemical tests as the superior FOB test for bowel cancer screening.