Effective Wednesday, May 16, 2012, a new fecal occult blood testing (FOBT) card will be available at the University of Iowa Hospitals and Clinics.  This is the Hemoccult® ICT (Beckman Coulter Inc.).  This card uses an immunochemical detection method for enhanced detection of blood originating from the lower gastrointestinal tract, including from colorectal cancers or precursor lesions.  Unlike guaiac-based cards, immunochemical methods are not subject to dietary interferences from red meat, plants, or vitamin C (ascorbic acid).  The preferred collection is home collection over two days.  It is anticipated that clinics will stock this card and distribute to patients with collection instructions and mailer to return the cards.  Digital rectal exam (DRE)-collected is not recommended for colorectal cancer screening.  Even with immunochemical detection methods, a single DRE specimen has low sensitivity for cancer screening.

It is intended that the Hemoccult ICT cards will replace guaiac-based cards in clinics that distribute cards to patients for colorectal cancer screening.  Hemoccult ICT will also replace the Polymedco immunochemical method ("FECAL OCCULT BLOOD IMMUNOASSAY", LAB5706) currently used in Family Care Center (FCC).  The Polymedco assay will be maintained until FCC can phase out this test over the course of the coming year.

The purchasing information for the Hemoccult® ICT product is listed below (contact John Burroughs, Hospital Product Representative at 319-467-5541 with procurement questions):

Peoplesoft Number	Description(60)	Ship Unit	Ship Price	Issue Unit	Issue Price
60068	Hemoccult Slides For Home Application And Mailing 2 day	BOX/50	$65.00	EACH	$1.30

It should be kept in mind that guaiac-based cards would still be appropriate for screening for gastrointestinal bleeding from any source (upper and lower GI tract).  The table below summarizes the fecal occult blood screening tests available in Epic, including the guaiac-based cards that will remain in supply:

Epic Name of Test	Epic #	Methodology	Result Component in Results Review
FECAL OCCULT BLOOD – IMMUNOCHEMICAL (HEMOCCULT ICT)	LAB7641	Immunochemical	FECAL OCCULT BLOOD – HEMOCCULT ICT
FECAL OCCULT BLOOD – IMMUNOCHEMICAL (POLYMEDCO)	LAB5706	Immunochemical	FECAL OCCULT BLOOD – POLYMEDCO
FECAL OCCULT BLOOD – GUAIAC	LAB1115	Guaiac	GUAIAC (FECAL OCCULT BLOOD)
GUAIAC, STOOL, POINT OF CARE	POC39	Guaiac	POC GUAIAC STOOL

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry Laboratory (384-9380, matthew-krasowski@uiowa.edu).