Prevention of colorectal cancer. Report of accredited laboratories in medicine on the use of immunological faecal occult blood testing

摘要

Background. This review summarizes information about the introduction of immunological faecal occult blood testing (iFOBT) in line with the screening for colorectal cancer in the outpatient area with statutory health insurance since 01 April 2017, in Germany. A field report of medical laboratories in patient care for iFOBT is also included. Objectives. The report responds to questions about the frequency of iFOBT laboratory orders as well as quality issues regarding preanalytic and analytic topics based on data analysis and practical experience from routine use in patient care. Materials and methods. The analysis is based on anonymous data of the members from the German Federation of Accredited Laboratories in Medicine (ALM) from 01 April 2017 to 30 June 2018 including 4,423,795 iFOBT provided by the laboratories to the outpatient physicians. Results. The rate of returned tests to the laboratories by physician's practices was only 62% (n = 2,725,849). In addition, 4% of the tests were not exploitable mainly due to false handling of the stool sampling by patients. Meanwhile, laboratory test criteria meet the quality requirements. Conclusions. Optimization of the implementation of the whole medical procedure of iFOBT is needed for better outcome in patient care. Here, we suggest approaches for practical solutions with defined aims in our concluding remarks.