Photo Credit: Mohammed Haneefa Nizamudeen

Fecal immunochemical tests (FITs) have variable sensitivity and specificity for detecting advanced colorectal neoplasia (ACN), according to a study published in the Annals of Internal Medicine. Barcey T. Levy, MD, PhD, and colleagues compared the performance characteristics of five commonly used FITs (with colonoscopy as the reference standard) in a cross-sectional study across three US academic medical centers and affiliated endoscopy units. For the study, 3,761 participants completed five FITs before colonoscopy: four qualitative tests (Hemoccult ICT, Hemosure iFOB, OC-Light S FIT, and QuickVue iFOB) and one quantitative test (OC-Auto FIT). The researchers found 320 participants had ACN (8.5%), including nine (0.2%) with colorectal cancer. Test positivity varied from 3.9% to 16.4% across FITs. Rates of unevaluable FITs varied from 0.2% to 2.5%. For detecting ACN, the sensitivity and specificity varied from 10.1% to 36.7% and from 85.5% to 96.6%, respectively. All differences in sensitivity between FITs were statistically significant apart from the difference between Hemosure iFOB and QuickVue iFOB. All differences in specificity were statistically significant.