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Related Experiment Video

Updated: Jul 26, 2025

Comparative Analysis of Automatic Fecal Analyzer versus Direct Wet Smear Microscopy for Detecting Parasitic Infections in Stool Samples

Comparative Analysis of Automatic Fecal Analyzer versus Direct Wet Smear Microscopy for Detecting Parasitic Infections in Stool Samples

Published on: April 25, 2025

Comparison and commutability study among four faecal immunochemical tests (FIT) systems.

Liesbet Deprez¹, Carolyn Piggott², Eline A E van der Hagen^3,4

¹European Commission, Joint Research Centre (JRC), Geel, Belgium.

Clinical Chemistry and Laboratory Medicine

|June 16, 2023

Summary

Faecal immunochemical tests (FIT) show significant bias between systems, hindering common screening thresholds. Researchers identified potential reference materials to develop a calibrator and reduce analytical bias in colorectal cancer screening.

Keywords:

commutability faecal immunochemical tests method comparison reference materials

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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection

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Published on: June 8, 2020

Area of Science:

Clinical Chemistry
Gastroenterology
Biomarker Analysis

Background:

Faecal immunochemical tests (FIT) are crucial for colorectal cancer screening and symptomatic patient triage globally.
Current FIT systems lack traceability to a common standard, leading to potential result non-equivalence.
Quantifying bias between FIT systems is challenging due to complex pre-analytical factors.

Purpose of the Study:

To quantify bias and correlation between four FIT systems.
To assess the commutability of candidate reference materials (RMs).
To investigate methods for improving FIT system standardization.

Main Methods:

Measuring a panel of 38 faecal samples across four FIT systems, minimizing pre-analytical variability.
Performing pairwise method comparisons.
Evaluating the commutability of seven candidate reference materials.

Main Results:

High correlations (0.944-0.970) were observed between FIT systems, but significant proportional bias (-30% to -35%) was found for one system.
Sample-specific biases (RSD ~20%) limited conclusions from the commutability study.
Two candidate RMs, prepared in system-specific buffers, showed better commutability.

Conclusions:

Proportional bias prevents the use of a universal threshold across all FIT systems.
Potential commutable RMs were identified for future studies aimed at developing a common calibrator.
Reducing analytical bias between FIT systems is essential for reliable colorectal cancer screening.