Faecal immunochemical tests: when quantitation is not enough
Menée aux Pays-Bas auprès de 21 078 participants, cette étude compare, en fonction de différents seuils de positivité, la précision de deux tests immunochimiques de recherche de sang occulte dans les selles pour détecter une néoplasie de stade avancé
Although the so-called bleeding phenotype provided an early and valuable marker for the presence of colorectal cancer and advanced adenoma, the development and application of the faecal immunochemical test (FIT) in colorectal cancer screening proved a slow revolution. The FIT is the faecal occult blood test that is replacing the ubiquitous guaiac faecal occult blood test of the last century. Guaiac, a tree resin, was found to turn blue in the presence of blood and hydrogen peroxide in the mid-1800s. Thus, it was gradually adopted as a means of detecting the presence of blood in the stool and subsequently as an aid to colorectal cancer diagnosis. Barrows and colleagues described the first faecal immunochemical assay for blood in faeces in 1978. It increased specificity for human blood and enabled the test sensitivity to be markedly increased. Prefectures across Japan adopted FIT-based colorectal cancer screening in the early 1990s, and in 1996, Italy piloted use of the test for population-based screening. In 2018, the World Endoscopy Organisation Colorectal Cancer Screening Committee marks 20 years of promoting organised population-based screening and the pivotal role of FIT. The commitment and enthusiasm of this group has driven colorectal cancer research and screening, with FIT screening being piloted or implemented in more than 50 countries.
The Lancet Gastroenterology & Hepatology , commentaire, 2017