Fecal blood testing aids colorectal cancer screening

The use of a fecal occult blood test (FOBT) by high-risk patients participating in a colonoscopy-based colorectal cancer screening program led to the discovery of a number of neoplastic lesions, Australian researchers report in the June issue of Gut.

As lead investigator Dr. Peter Bampton told Reuters Health, “screening colonoscopy is not infallible — significant lesions can be missed. By adding in an FOBT between colonoscopies you can reduce this miss rate.”Dr. Bampton of Flinders Medical Center, Bedford and colleagues determined if the use of an FOBT between colonoscopy screening can detect significant pathology in individuals already enrolled in a screening program because of a personal or family history of colorectal neoplasias. Another study aim was to see how many patients would be willing to participate.In total, 785 (47.8%) of 1641 subjects invited by mail participated in immunochemical FOBT screening.A positive result was obtained for 57 and 52 underwent colonoscopy. Fourteen of the patients (1.8%) had significant neoplastic lesions. These consisted of six colorectal cancers and eight significant adenomas.The researchers conclude that the approach is feasible, given the nearly 50% participation rate. They also suggest that “at least one FOBT should be considered in the interval between surveillance colonoscopies, particularly in those patients who have a past history of colorectal neoplasia.”(Source: Gut 2005;54:803-806: Reuters Health: Oncolink: June 2005.)