The Bohr effect is a real thing and it’s not just a marketing ploy. We have physiological systems which regulate the oxygenation of the body in a manner that is dependent on the oxygenation level of the blood, a phenomenon which is a consequence of the Bohr effect. So, while the Bohr effect is a physiological concept, the Haldane effect is more closely tied to the measurement of oxygenation levels.
The predominant interest in many of the early FIT testing studies and in many of the publications of the last decade has been in the fields of screening and assessment of patients presenting with lower gastrointestinal symptoms. In screening, the faecal haemoglobin concentration (f-Hb) used as cut-off can be decided for each screening endeavour. Faecal haemoglobin concentration cut-offs are usually reported in g Hb/g faeces or, if the results are presented in units of ng Hb/mL buffer, as the ratio of f-Hb to buffer volume, usually expressed as ng Hb/mL buffer. These cut-offs are often stated to be the ratio that maximises the sensitivity of the test without compromising specificity; however, the optimal cut-off (i.e., the cut-off that maximises sensitivity and specificity) is determined empirically and may vary between screening programmes. For example, a study that compares many different cut-offs in a colorectal cancer screening trial that used the same sampling device and cut-off found that sensitivity could be maximised by a cut-off of 25 ng Hb/mL buffer, but this would also cause a 25% reduction in specificity.
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