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What is the role of iFOBT in screening for colorectal cancer?
  1. David F Ransohoff
  1. Correspondence to:
    David F Ransohoff
    CB7080, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080, USA; ransohof{at}med.unc.edu

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Policy makers will need to consider if it has one, not only as an adjunct to gFOBT screening, but also as a primary screening test

Screening for colorectal cancer (CRC) using gFOBT (guaiac based faecal occult blood test) has been shown in randomised controlled trials (RCTs) to reduce CRC mortality.1–3 gFOBT testing is endorsed as an option for CRC screening in the United States4–7 and is being implemented in the United Kingdom. People with a positive gFOBT receive colonoscopy to detect early cancers and advanced adenomas that, if untreated, might cause CRC mortality. Because gFOBT has a high rate of false positive results, however, gFOBT screening can incur substantial cost and use of colonoscopy resources. A method that could determine which people with a positive gFOBT have false positive results—and do not need colonoscopy—would make gFOBT screening more practical.

A study in this issue of Gut8 Fraser et al(see p 1415) shows that doing iFOBT (human haemoglobin immunochemical based FOBT) in people with a …

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