Quantitative analysis of haemoglobin in stool – importance for colorectal cancer screening

06/2017

MUDr. Petr Kocna, CSc.

Ústav lékařské biochemie a laboratorní diagnostiky, 1. LF UK a VFN Praha

SUMMARY

Colorectal cancer screening has a long tradition in the Czech Republic. High specificity of screening tests is a prerequisite for use in mass screening. Unlike individual diagnostics, there is a higher risk of false positivity than negativity in population screening because it leads to increased costs, unnecessary investigation, complications, and a negative impact on the quality of life of healthy people. Quantitative haemoglobin detection in stool is currently the most accurate method of determining occult bleeding suitable for colorectal cancer screening. Optimization of screening is addressed in all countries where faecal immunochemical test (FIT) has replaced guaiac tests and involves cut-off criteria for positivity, number of tests performed, combination of FIT with other biomarkers, and distribution and sample analysis. Standardization and harmonization of FIT is a prerequisite for population screening of colorectal cancer and the accuracy and reliability of quantitative detection of haemoglobin in the stool should be ensured by external quality control.

KEY WORDS

colorectal cancer, screening, occult bleeding, quantitative immunochemical detection