Quality Indicators and Benchmarks for Guideline-Recommended Fecal Occult Blood Tests

The fecal immunochemical test (FIT) for hemoglobin is beginning to be accepted as a legitimate and attractive choice for use as a screening test for colorectal cancer in the USA, but, as yet, many primary care physicians, gastroenterologists, health policy experts, and US laboratory professionals remain unfamiliar with FIT’s usefulness and potential or do not understand why quality standards and benchmarks are critical to FIT effectiveness and for their evaluation. All such stakeholders must understand the need for FIT refinement and standardization to ensure traceability of analytical results, consistency in fecal sample mass evaluation, assessment of hemoglobin (Hb) stability, and common units for reporting Hb concentrations. We hope this chapter will help provide the reader with an understanding of the importance of adopting a standardized approach to FIT nomenclature, to the measurement of fecal Hb (f-Hb) concentrations, and of how FIT results are reported.