What is the evidence surrounding immunochemical Faecal Occult Blood Tests (FOBTs)?
Randomised controlled clinical trials at the population level have indicated that screening using FOBTs, in populations selected on the basis of age, can reduce overall mortality from colorectal cancer by 15-33% [1]. During this phase of the National Program, an immunochemical FOBT called ‘Detect’ will be used. Detect requires the collection of faecal samples from two separate bowel motions and does not require dietary modification prior to the test being completed. According to NHMRC’s Clinical Practice Guidelines for the Prevention, Early Detection and Management of Colorectal Cancer, immunochemical FOBTs detect 60-90% of cancers and many advanced adenomas under ideal conditions. The NHMRC Guidelines recommend that screening with FOBT be performed at least once every two years [2]. During the pilot program the positive predictive value of the Detect FOBT for suspected cancer or advanced adenoma was 20.1%. For all cancers and adenomas, including small and diminutive adenomas, the posi
