RSS Feeds
Quantitative Immunochemical Fecal Occult Blood Test for Diagnosing Colorectal Neoplasia
- Paul Rozen, MBBS;
- Zohar Levi, MD; and
- Yaron Niv, MD
- From Rabin Medical Center, Beilinson Hospital, and Tel Aviv University, Petach Tikva and Tel Aviv, Israel.
IN RESPONSE:
We thank Drs. Shastri and Stein for their comments and their very relevant questions, which provide us with an opportunity to address several important clinical issues. First, our comment on “systematic evaluation” refers to the automated developed and quantitative immunochemical FOBT. As Drs. Shastri and Stein point out, they, we, and others have evaluated the office-developed immunochemical FOBT (1, 2). However, the test uses a fixed threshold set by the manufacturer, and the hand development is not conducive for large-scale population screening. Evaluating the immunochemical FOBT as a laboratory test, with a quantified result, allows the treating physician to use his or her clinical judgment as for any other laboratory test. Second, the number of requested stool samples definitely influences screening adherence. In our study population, which is used to collecting 3 guaiac-based FOBTs, this was not an issue. However, we are now completing a study on an average-risk population, which will allow us to evaluate adherence in persons in this population who, to date, have not participated in FOBT screening. Third, the maximum cost of FOBT screening is set by our Ministry of Health because this test is available for the total population through their own health maintenance organization. The $20 cost is the total cost per patient that was estimated by the local agent for this immunochemical FOBT. This will need to be budgeted by the health maintenance organization, which is required to provide, at no cost, an annual FOBT to average-risk members.
Paul Rozen, MBBS
Zohar Levi, MD
Yaron Niv, MD
Rabin Medical Center, Beilinson Hospital, and Tel Aviv University
Petach Tikva and Tel Aviv, Israel
Potential Financial Conflicts of Interest: None disclosed.
