Faecal occult blood testing for colorectal cancer screening: the past or the future

Abstract

Screening for colorectal cancer (CRC) reduces CRC mortality; many countries have implemented population-based CRC screening programmes and many more are poised to do so. Whilst several different CRC screening modalities are available, choice will be influenced by cost, available resources (e.g. high-quality colonoscopy) and acceptability of the test by the invited population. For CRC screening, no screening test has so far surpassed the practicality, affordability and effectiveness of tests for the presence of blood in faeces (faecal occult blood tests, FOBt). The results of several large FOBt-based randomised controlled trials provide the best clinical evidence to support their use in population-based CRC screening. This review considers the current options for CRC screening and the future for FOBt.