Testing for blood in the stool is one of several modalities recommended by national organizations for colorectal cancer (CRC) screening. However, CRC screening using conventional guaiac-based Fecal Occult Blood Test (gFOBT) has not been useful in many Alaska Native populations due to a high prevalence of Helicobacter pylori (H. pylori) infection in the stomach. In this population H. pylori causes low grade chronic blood loss from the stomach and has discouraged use of FOBT as a screening modality. Diets high in red meat compound the problem. The immunochemical fecal occult blood test (iFOBT) is a newer human hemoglobin-specific stool blood assay which is possibly more specific and sensitive than gFOBT in the detection of colorectal neoplasia, is not confounded by upper gastrointestinal bleeding, and does not require the dietary restrictions required by the gFOBT. However, the iFOBT has not been evaluated in the Alaska Native population.

The purpose of this study is to assess whether iFOBT is a reasonable screening option for CRC in Alaska Native people. In addition, we propose to establish that among those persons with H. pylori infection, gFOBT does lead to a high proportion of false positives and therefore should not be recommended as a screening test in this population. Alaska Native people will be recruited during their pre-op visit for screening or surveillance colonoscopies at ANMC.

The FIT study began enrolling participants at Alaska Native Medical Center in April 2008. The duration of the study will be 2-3 years with a total of 300 participants.

For more information contact please contact the EpiCenter.

• Further Information
  • FIT Study Detailed Overview
  • Guidelines for the Diagnosis and Treatment of Helicobactor pylori
  • Memorandum of Approval from ANMC Chief of Surgery