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Technical Bulletins

Technical Bulletins

Anatomic Pathology Services Fecal Immunochemical (FIT) North Shore-LIJ Laboatories offers comprehensive Test Updates for Physicians, including Fecal Immunochemical Test (FIT) and Anatomic Pathology Resources.
 

Fecal Immunochemical Test (FIT)

Each year, 146,000 new cases of colorectal cancer (CRC) are diagnosed in the U.S., and 60% of these patients have metastatic disease at the time of diagnosis. About 56,000 CRC patients die of their disease each year, and it’s estimated that more than half could have been saved by effective screening and earlier diagnosis. Unfortunately, compliance with screening tests is low.

Screening tests for fecal occult blood have been shown to significantly reduce CRC mortality. The guaiac method has been used for many years, but it requires a three to five day abstention from aspirin, NSAIDS, red meat, poultry, fish, certain vegetables, and vitamin C. The guaiac method also detects blood of upper GI origin, which is usually due to gastric inflammatory disease, rather than CRC.

The new fecal immunochemical test (FIT) for occult blood has solved many of these problems. This method is highly specific for the globin portion of human hemoglobin and is easy for patients to use. It requires no dietary or medication restrictions, and it does not detect blood of upper GI origin. This means better patient compliance and fewer false-positive tests due to gastric inflammation or medications.

North Shore-LIJ Laboratories offers the FIT as a screening test for colorectal cancer. Each single-use kit contains easy-to-understand instructions and a patient-friendly collection device. There is also a useful brochure that discusses CRC and screening.

References

  • Noninvasive Testing for Colorectal Cancer: A Review
  • Ouyang, D et al, Am J Gastroenterol. 2005; 100(6): 1393-1403
  • Emerging Technologies in Screening for Colorectal Cancer
  • Levin, B et al, CA Cancer J Clin 2003; 53: 44-55

Test Information

Description: Fecal Immunochemical Test (FIT)
Method: Immunoassay
Order Code: IFOBT
CPT Code: 82274 (Yearly screen billed to Medicare as G0328.)

Specimen: Random stool sample collected with the Polymedco collection probe. Scrape stool with surface of probe. Stool must cover the grooved portion of probe. There are no dietary restrictions, and only a single, one-day sample is necessary. Store and transport at room temperature. Collection devices available from North Shore-LIJ Supply Department.

Comments: Alternative sample: Obtain sample from toilet paper, not from toilet bowl. If Polymedco collection probe is not used, store and transport refrigerated. Stability: 5 days at room temperature, 14 days refrigerated.

Schedule: Monday to Saturday

Turnaround: 1-2 days

Ranges: Negative

Quick Facts

Screening for colorectal cancer can save lives.

The FIT for occult blood offers these benefits:

  • No dietary or medication restrictions required.
  • Easy single sample collection.
  • Improved patient compliance.
  • Fewer false-positive results.
  • Stable 14 days refrigerated, 5 days at room temperature.

The American Cancer Society provides the following recommendations:

  • "In comparison with guaiac based tests for the detection of occult blood, immunochemical tests are morepatient-friendly and likely to be equal or better in sensitivity and specificity."
  • Annual testing for fecal occult blood is recommended after age 50 for all men and women at average risk for colorectal Cancer.

For more information, please contact Client Services at (516) 719-1100.

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Anatomic Pathology Services

We are committed to providing reliable and timely diagnostic reports that fulfill the needs and expectations of our physician clients and their patients.

North Shore-LIJ Laboratories provides comprehensive anatomic pathology services tailored to the needs of outpatient care. In addition, this service provides the opportunity for continuity of care between outpatient and inpatient visits. Accredited by the College of American Pathologists (CAP) and CLIA, the NSLIJ Laboratories staff is committed to providing quality service to the communities that they serve. Testing services include: 

  • Cytopathology. We offer full service Cytopathology, including analysis of body fluids, fine needle aspirates, conventional pap smears and ThinPrep® pap smears. A dedicated team of cytotechnologists and pathologists are committed to providing reliable and timely results.
  • HPV DNA testing. HPV has been proven to be the primary cause of cervical cancer in women age 30 and over. NSLIJ Core Laboratory offers High Risk HPV DNA testing as a primary screening option in conjunction with the Pap test. HPV testing is also offered as a reflex test for abnormal Pap tests to aid in the management of these patients.
  • Surgical pathology. Our pathologists are board certified with subspecialty certification in cytopathology, hematopathology, and dermatopathology. These pathologists have broad experience in the diagnostic interpretation of:
    • Breast Pathology
    • Prostate Pathology
    • Dermatopathology
    • Gastrointestinal Pathology
    • Gynecologic Pathology
    • Hematopathology (bone marrow and lymph node pathology)
    • Endocrine Pathology
  • Ancillary diagnostic procedures include
    • Immunohistochemistry
    • Immunofluorescence
    • Solid Tumor Immunophenotyping
    • Lymphoma/Leukemia Immunophenotyping
    • Flow Cytometry
    • Fluorescent In-Situ Hybridization (FISH)
    • HER-2/neu, Estrogen Receptor/Progesterone Receptor
    • Urological Testing (Urovysion)
  • Quality assurance. NS-LIJ Laboratories has an extensive quality assurance program in anatomic pathology.
    • Pathologists monitor cytologic-biopsy correlations and utilize consensus conferences.
    • Technical staff ensures reliable and timely reporting by monitoring specimen identification, specimen integrity and turn-around-time.
    • Professional and technical staff participates in proficiency testing administered by the College of American Pathologists (CAP), New York State Department of Health (NYSDOH), and other regulatory agencies.

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