Immunologische Stuhlbluttests zur Darmkrebsfrüherkennung

Fecal immunochemical tests for hemoglobin (FIT) offer several advantages over guaiac-based fecal occult blood testing in colorectal cancer screening, e. g. regarding diagnostic accuracy and participation rates. There are different FITs on the market, namely qualitative FITs (point-of-care tests) and quantitative FITs. Although the European Guidelines for quality assurance in colorectal cancer screening only recommend quantitative FITs, there are continued endeavors to question this and to also allow qualitative FITs as an option. In this commentary, we explain the problems that qualitative FITs pose in terms of quality assurance, particularly regarding the sustained control of the positivity threshold. We further show that various arguments raised in favor of qualitative FITs do not stand up to a critical and rational examination. The use of qualitative FITs is thus not a tenable option for a quality-assured screening program.