Systematic review of faecal occult blood tests used in population screening for colorectal cancer


This review was commissioned to inform the NHS Cancer Screening Programme introduction of a colorectal cancer screening programme in the UK using FOB testing. The purpose of the review was to assess which of the guaiac-based and/or immunochemical FOBTs (or combination of tests) would be the most effective and cost-effective for use in this setting.


Studies that included direct comparisons indicated a better overall test performance for immunochemical than for guaiac FOBTs, but this evidence was very limited and of poor quality. Indirect comparisons showed no clear evidence to suggest that either guaiac or immunochemical FOBTs performed better. Poor reporting of data limited the scope of this review. We would encourage investigators to use the STARD guidelines when reporting diagnostic accuracy studies.

Conducted by: Karla Soares-Weiser1, Jane Burch1, Steven Duffy1, James St John2, Stephen Smith3, Marie Westwood1, Jos Kleijnen1

1. Centre for Reviews and Dissemination; 2. The Cancer Council Victoria, Australia; 3. University Hospitals of Coventry & Warwickshire


Centre for Reviews and Dissemination. Diagnostic accuracy and cost-effectiveness of faecal occult blood tests (FOBT) used in screening for colorectal cancer: a systematic review. CRD Report 36. York: University of York. 2007

Burch JA, Soares-Weiser K, St John DJB, Duffy S, Smith S, Kleijnen J, Westwood M. Diagnostic accuracy of faecal occult blood tests used in screening for colorectal cancer: a systematic review. J Med Screen. 2007;14(3): 132-7


Burch J, Westwood M, Soares-Weiser K. Should data from case-controlled studies be included in systematic reviews alongside diagnostic cohort studies? 14th Cochrane Colloquium; 2006 October; Dublin, Ireland


Commissioned by NHS Cancer Screening Programmes