Gastroenterology clinic

Faecal occult blood tests. How and when to use (or not)

GRAEME P. YOUNG, ERIN L. SYMONDS

Figures

BACKGROUND PHOTOGRAPH: © ANDREY POPOV/ISTOCKPHOTO.COM. FOREGROUND: HOME TEST KIT INSTRUCTIONS © SONIC HEALTHCARE
BACKGROUND PHOTOGRAPH: © ANDREY POPOV/ISTOCKPHOTO.COM. FOREGROUND: HOME TEST KIT INSTRUCTIONS © SONIC HEALTHCARE

Abstract

The most appropriate use of a faecal occult blood test is screening in people who are of average risk for colorectal cancer – namely, individuals aged between 50 and 74 years and without symptoms or risk factors that warrant colonoscopy surveillance. The faecal immunochemical test is now the technology of choice. To obtain the best results, faecal samples should be collected by the person who is being screened, following the instructions provided with the test kit.

Article Extract

Remember
  • Faecal occult blood tests (FOBTs) are most accurate when stools are sampled correctly.

  • Screening average-risk people for colorectal cancer (CRC) is the main and near-exclusive indication for use of  FOBTs. The faecal immunochemical test (FIT) is the best technology.

  • In people who are at increased risk for CRC, colonoscopy should be considered as the first-line option.

  • An FOBT of any type should not be repeated to confirm an already-positive test result.

  • An FOBT of any type should not be offered to people who are not able or not willing to undergo colonoscopy if indicated.

  • The risk for colorectal neoplasia is low for at least the first four years after a high-quality colonoscopy in a person at average risk.

  • The Australian National Bowel Cancer Screening Program (NBCSP) provides a suitable program using FIT for screening people at average risk.

Figures

BACKGROUND PHOTOGRAPH: © ANDREY POPOV/ISTOCKPHOTO.COM. FOREGROUND: HOME TEST KIT INSTRUCTIONS © SONIC HEALTHCARE
BACKGROUND PHOTOGRAPH: © ANDREY POPOV/ISTOCKPHOTO.COM. FOREGROUND: HOME TEST KIT INSTRUCTIONS © SONIC HEALTHCARE