The MSAC considers that faecal occult blood testing is useful for population health screening to reduce CRC mortality.
The available evidence indicated that there was no apparent class effect of the guaiac versus immunochemical FOBTs with regard to their effectiveness or cost-effectiveness.
Different brands of FOBTs possess different sensitivities and specificities for the detection of CRC within an average risk screening population setting. The specificity of the FOBTs was a major determinant of the total associated costs of FOBT screening, inclusive of diagnostic follow-up and treatment.
An economic model indicated that biennial screening was more cost-effective than annual screening, within the context of the main analysis. Lowering the minimum eligible screening age from 55 to 50 years offered benefits in terms of cost-effectiveness. Increasing the maximum screening age from 75 to 80 years did not offer the same degree of benefit.
The immunochemical tests included in the assessment are no longer available and they have been replaced by newer assays. There was no available evidence suitable for the assessment of the comparative performance of currently available immunochemical tests within an average risk population health screening setting. However, the results of the analyses of the immunochemical tests used may reflect those for FOBTs with similar technical characteristics (ie, in vitro diagnostic accuracy for the detection of haemoglobin). Therefore, it is suggested that currently available and new immunochemical tests with promising technical characteristics be evaluated against established FOBTs within the context of an ongoing screening program.
