Dear OncoLink "Ask The Experts,"
Is the immunochemical fecal occult blood test (iFOBT) currently being used for community-based colorectal screening that you know of? This test does not require the fasting needed with the gFOBT test and may be more attractive. Medicare currently covers the cost of the iFOBT but I wondered whether you had any anecdotal evidence of it being used for a community screening.
Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:
I do not know of anyone who is using the iFOBT. While fecal occult blood testing has been proven to be an effective way of screening for colon cancer, most of the screening has now changed to colonoscopies. Too many of the FOBTs were positive without cancer or were negative despite cancers being present (a problem of sensitivity and specificity). While iFOBT has been proven to be more accurate in detecting hemoglobin in the stool (not from the diet), it has not achieved much usage in our institution. It may be worthwhile to contact the manufacturer if you need to use this product.