Editing Stool test (section)

==Cancer screening==
[[Fecal occult blood test]] and [[fecal immunochemical test]] are the most common stool tests to diagnose many conditions that caused by bleeding in the [[gastrointestinal system]], including [[colorectal cancer]] or [[stomach cancer]].<ref>{{cite web |title=Fecal Occult Blood Test (FOBT) |url=http://www.webmd.com/hw/colorectal_cancer/hw227116.asp}}</ref>  The American College of Gastroenterology has recommended the abandoning of gFOBT testing as a colorectal cancer screening tool, in favor of the [[fecal immunochemical test]] (FIT).<ref>{{cite journal |vauthors=Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM |date=March 2009 |title=American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected] |journal=The American Journal of Gastroenterology |volume=104 |issue=3 |pages=739–750 |doi=10.1038/ajg.2009.104 |pmid=19240699 |s2cid=295873|doi-access=free }}</ref>  The newer and recommended tests look for [[globin]], [[DNA]], or other blood factors including [[transferrin]], while conventional [[stool guaiac test]]s look for [[heme]].

Cancers, and to a lesser extent, precancerous lesions, shed abnormal cells into the stool.<ref name="Osborn NK 2005">{{cite journal |last1=Osborn |first1=NK |last2=Ahlquist |first2=DA |date=2005 |title=Stool screening for colorectal cancer: molecular approaches |journal=Gastroenterology |volume=128 |issue=1 |pages=192–206 |doi=10.1053/j.gastro.2004.10.041 |pmid=15633136|doi-access=free }}</ref> Cancers and precancerous lesions ([[Polyp (medicine)|polyps]]) that are ulcerated or rubbed by passing stool also may shed blood into the stool, which can be identified by a hemoglobin assay.<ref name="Osborn NK 2005" />  

The [[American Cancer Society]] and the [[U.S. Preventive Services Task Force]] recommended colorectal cancer screening with a [[fecal immunochemical test]] every year, or  a multi-target stool DNA test for every three years from the age of 45.<ref name=":0">{{cite journal |last1=Tepus |first1=M |last2=Yau |first2=TO |date=20 May 2020 |title=Non-Invasive Colorectal Cancer Screening: An Overview |journal=Gastrointestinal Tumors |volume=7 |issue=3 |pages=62–73 |doi=10.1159/000507701 |pmc=7445682 |pmid=32903904 |doi-access=free}}</ref> Other options include a [[sigmoidoscopy]] or [[virtual colonoscopy]] (CT colonography) for every five years or a [[colonoscopy]] for every 10 years.
[[Fecal occult blood test]] is no longer recommended due to the high false-positive rate as well as the dietary and pharmaceutical restrictions.<ref name=":0" /><ref>{{cite web |title=American Cancer Society recommendations for colorectal cancer early detection |url=http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations |access-date=14 July 2016 |website=www.cancer.org |archive-date=3 December 2016 |archive-url=https://web.archive.org/web/20161203205348/http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations |url-status=dead }}</ref> The [[National Committee for Quality Assurance]] (NCQA) issued an update to the [[Healthcare Effectiveness Data and Information Set]] (HEDIS) for 2017, while the guideline remains for the patients aged 50 or over.<ref>{{cite web |last1=National Committee for Quality Assurance |title=Healthcare Effectiveness Data and Information Set 2017 Volume 2: Technical Update |url=http://www.ncqa.org/Portals/0/HEDISQM/HEDIS2017/HEDIS%202017%20Volume%202%20Technical%20Update.pdf?ver=2016-10-03-114902-317}}</ref>

A multi-target stool DNA test was approved in August 2014 by the FDA as a screening test for non-symptomatic, average-risk adults 50 years or older.<ref name="Food and Drug Administration press release">{{cite web |date=August 11, 2014 |title=FDA approves first non-invasive DNA screening test for colorectal cancer [press release] |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm409021.htm |archive-url=https://web.archive.org/web/20140812180130/http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm409021.htm |url-status=dead |archive-date=August 12, 2014 |access-date=30 June 2015 |website=Food and Drug Administration}}</ref> A 2017 study found this testing to be less [[cost effective]] compared to colonoscopy or fecal occult blood testing.<ref name="Bar2017">{{cite journal |last1=Barzi |first1=A |last2=Lenz |first2=HJ |last3=Quinn |first3=DI |last4=Sadeghi |first4=S |date=1 May 2017 |title=Comparative effectiveness of screening strategies for colorectal cancer. |journal=Cancer |volume=123 |issue=9 |pages=1516–1527 |doi=10.1002/cncr.30518 |pmid=28117881 |doi-access=free|pmc=6879196 }}</ref> Three-year multi-target stool DNA test has been estimated to cost $11,313 per [[quality-adjusted life year]] (QALY) compared with no screening.<ref>{{cite journal |last1=Berger |first1=BM |last2=Shroy |first2=PC |last3=Dinh |first3=TA |year=2015 |title=Screening for Colorectal Cancer Using a Multitarget Stool DNA Test: Modeling the Effect of the Intertest Interval on Clinical Effectiveness. |url=http://www.clinical-colorectal-cancer.com/article/S1533002815001541/pdf |journal=Clinical Colorectal Cancer |volume=15 |issue=3 |pages=e65–e74 |doi=10.1016/j.clcc.2015.12.003 |pmid=26792032 |doi-access=free}}</ref>