Fecal occult blood test and
fecal immunochemical test are the most common stool tests to diagnose many conditions that caused by bleeding in the
gastrointestinal system, including
colorectal cancer or
stomach cancer. The American College of Gastroenterology has recommended the abandoning of gFOBT testing as a colorectal cancer screening tool, in favor of the
fecal immunochemical test (FIT). The newer and recommended tests look for
globin,
DNA, or other blood factors including
transferrin, while conventional
stool guaiac tests look for
heme. Cancers, and to a lesser extent, precancerous lesions, shed abnormal cells into the stool. Cancers and precancerous lesions (
polyps) that are ulcerated or rubbed by passing stool also may shed blood into the stool, which can be identified by a hemoglobin assay. Other options include a
sigmoidoscopy or
virtual colonoscopy (CT colonography) for every five years or a
colonoscopy for every 10 years.
Fecal occult blood test is no longer recommended due to the high false-positive rate as well as the dietary and pharmaceutical restrictions. The
National Committee for Quality Assurance (NCQA) issued an update to the
Healthcare Effectiveness Data and Information Set (HEDIS) for 2017, while the guideline remains for the patients aged 50 or over. A multi-target stool DNA test was approved in August 2014 by the FDA as a screening test for non-symptomatic, average-risk adults 50 years or older. A 2017 study found this testing to be less
cost effective compared to colonoscopy or fecal occult blood testing. Three-year multi-target stool DNA test has been estimated to cost $11,313 per
quality-adjusted life year (QALY) compared with no screening. ==Microbiology tests==