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PubMed1984

Hematuria and false-positive tests for stool occult blood.

A false-positive test for occult blood may result when stool samples are collected from a toilet bowl contaminated with urine that contains blood. This was the case in three patients subjected to extensive work-up for gastrointestinal bleeding. In vitro tests confirmed this reaction. Hematuria may not be noted by the patient, or it may be masked by colored toilet bowl cleaners when samples for test cards are collected at home.

False Positive Reactions↗
PubMed1979

Nonuniform distribution of occult blood in feces.

Inhibition of anti-Rh29 by erythrocytic stroma in feces was devised as a specific test for fecal occult blood. The sensitivity of this test was equivalent to that of a standard Hemoccult test, namely, 10(8) erythrocytes/g feces. Comparison of results of this test with results of Hemoccult tests of random stool specimens and of stools following ingestion of autologous blood revealed nonuniform distribution of occult blood in feces. The extent of nonuniformity was determined by testing samples of stool specimens following ingestion of 51Cr-labeled autologous blood. This allowed comparison of Hemoccult, inhibition of anti-Rh, and radioactivity, and showed that the three labels could separate in the feces and that some single small samples of feces could be relatively free of blood while blood was readily demonstrable in other portions. The variability of standard Hemoccult test was somewhat reduced by dispersing the feces in distilled water before performing the test.

Chromium Radioisotopes↗
PubMed1992

Colorectal cancer screening: optimal compliance with postal faecal occult blood test.

Five approaches to postal faecal occult blood test (FOBT) were compared in a population sample of 966 subjects collected from three general practitioner patient lists in Southern Sydney. The highest compliance rate (59.8%) was achieved by a method using a general practitioner letter, with no dietary restrictions with FOBT. This was also the least expensive method. Compliance rates can be affected by incorrect address information and screenees not considering themselves to be current patients. An explanation from the family doctor addressed personally to the patient with an enclosed FOBT kit can achieve high compliance rates.

Aged↗
PubMed2001

Age-related cancer detection rate and costs for one cancer detected in one screening by immunochemical fecal occult blood test.

PURPOSE: This study was performed to assess, from the aspects of screening efficiency and cost-effectiveness, the optimal lower limit of age in immunochemical occult blood screening for colorectal cancer. METHODS: Seven thousand four hundred asymptomatic individuals were the subjects of this study. They gave samples for an immunochemical fecal occult blood test (OC-Hemodia), and colonoscopy was performed during a medical checkup. They were divided into three groups according to their ages: younger (40-49), middle (50-59), and older (60+) groups. The detection rate for colorectal cancer and the average costs to detect one patient with colorectal cancer were evaluated among the three groups. RESULTS: The detection rate for colorectal cancer and the average costs to detect one cancer patient were calculated as 0.3 percent and $6024 for the younger group, 1.6 percent and $1425 for the middle group, and 1.7 percent and $1410 for the older group, respectively. The cancer detection rate was significantly different between the younger and middle groups (P < 0.05) and between the younger and older groups (P < 0.05). CONCLUSIONS: This analysis suggests that the subjects aged less than 50 have some disadvantage when carrying out the immunochemical fecal occult blood test, OC-Hemodia for colorectal cancer screening, from the aspects of screening efficiency and cost-effectiveness.

Adult↗
PubMed1997

Fecal occult blood testing for colorectal cancer. Can we afford not to do this?

Current practice guidelines recommend annual fecal occult blood test screening for colorectal cancer in the average-risk population over the age of 50. Efficacy of fecal occult blood test screening is supported by several controlled prospective trials and case-control studies. Implementation of this recommendation, in combination with periodic flexible sigmoidoscopy every 5 years, is feasible, affordable, highly effective, and has the potential for reducing colorectal cancer mortality by at least 50%. With over 50,000 Americans dying of this malignancy each year, we cannot afford not to do this.

Colorectal Neoplasms↗
PubMed1988

Occult blood in stools and necrotizing enterocolitis. Is there a relationship?

A prospective study was undertaken to determine the incidence of occult hematochezia in enterally fed low-birth-weight neonates (less than 1800 g at birth). The relationship of this occult hematochezia to the development of necrotizing enterocolitis (NEC) was then analyzed. Daily stool specimens from 95 neonates were tested for occult blood during the first six weeks of life. Fifty-four (58%) of the 95 neonates had one or more blood-positive stools. Six neonates (6.3%) developed NEC. Necrotizing enterocolitis occurred in only two of the 54 neonates with one or more blood-positive stools vs four of the 41 neonates with blood-negative stools only. Presence of occult blood in the stools did not correlate with development of NEC.

Enteral Nutrition↗
PubMed1997

Clinico-pathological features of colorectal adenomatous polyps with negative results on immunochemical fecal occult blood test.

BACKGROUND: This study was carried out to clarify the clinico-pathological features of colorectal adenomatous polyps showing negative results on an immunochemical fecal occult blood test. METHODS: Four hundred sixty patients with colorectal adenoma 1.0 cm or larger in diameter served as subjects of this study. They were divided into two groups based on the results of an immunochemical fecal occult blood test with a 3-day method: two hundred twenty four patients with positive results (positive group) and two hundred thirty six patients with negative results (negative group). The above two groups were compared in terms of their individual factors such as lesion site, lesion size, lesion shape, and histological type. RESULTS: In negative group, the frequencies of rectal adenomatous polyps (p<0.01) and colorectal adenomatous polyps 1.0-1.5 cm in size (p<0.001) were higher, and also pedunculated type (p<0.05) were lower than in positive group, but there was no difference in histological type between the two groups. CONCLUSIONS: These findings suggest that immunochemical fecal occult blood testing is relatively inferior for the detection of colorectal adenomatous polyps in rectum, smaller size, and non-pedunculated type.

Adenoma↗
PubMed1980

Fecal occult blood tests in cattle.

Three methods for fecal occult blood detection were evaluated in mature cows. Bovine blood (heparinized) was infused directly into the abomasum of mature nonlactating rumen-fistulated cows. After administration of the blood, feces from the cows were periodically collected, tested, stored, and retested. Sensitivity for two of the three methods was optimal at 2 days of storage, regardless of temperature at storage. A dilute alcoholic solution of guaiac was the most sensitive and reproducible method. In vitro tests demonstrated that guaiac solution could detect a quantity of blood comparable with a daily blood loss of 69 to 75 ml. In addition, the minimal transit time of blood from abomasum to rectum was measured and ranged from 7 to 19 hours.

Animals↗
PubMedDate not supplied

Characteristics and survival rate of elderly patients with colorectal cancer detected by immunochemical occult blood screening.

BACKGROUND/AIMS: A comparative study was carried out to clarify the clinicopathological features and survival rate of elderly patients with colorectal cancer diagnosed by immunochemical fecal occult blood screening. METHODOLOGY: The study subjects included 208 patients with colorectal cancer, who were divided into 2 groups based on their ages: 52 patients aged 75 years and over (older group) and 156 patients aged 50-74 years (younger group). The 2 groups were compared in terms of their individual factors, including site, size, Dukes' classification, histo-pathological type of their cancer lesions and 5-year survival rate. RESULTS: There was a significant difference in prevalence of tumor sites between the older and younger groups (P < 0.05). Particularly, the frequency of right colon cancers was higher in the older group (34.6%) than in the younger group (20.5%), but there were no differences found in any other factors such as size, Dukes' classification, and histopathological type. Survival rate was almost the same between the 2 groups. CONCLUSIONS: These results suggest that elderly patients are susceptible to right colon cancer but there is no difference in the clinicopathological characteristics and 5-year survival rate between older and younger patients with colorectal cancer detected by immunochemical fecal occult blood test. The older as well as younger people should be encouraged to attend the screening program for colorectal cancer by immunochemical fecal occult blood test.

Adenocarcinoma↗
PubMed2000

A cost-effective analysis of the optimum number of stool specimens collected for immunochemical occult blood screening for colorectal cancer.

This study was carried out to assess, from the viewpoint of cost-effectiveness, the optimum number of faecal specimens to collect for use in immunochemical occult blood testing as a means of screening for colorectal cancer. 3300 asymptomatic individuals were subjects of this study. They gave samples for an immunochemical faecal occult blood test, monohaem and colonoscopy was carried out during a medical check-up. For evaluation of the optimum number of sampling specimens, the results of the first day of sampling, those of the first and second days, and those of samples taken for 3 consecutive days were considered as the single-day method, the 2-day method and the 3-day method respectively. The average cost to detect 1 patient with colorectal cancer, the detection rate and the false-positive rate of these three faecal sample collection methods were evaluated. The average costs for one cancer case detected were calculated as $3,630.68 for the single-day method, $3,350.65 for the 2-day method and $4,136.36 for the 3-day method, respectively. The detection rate and the false-positive rate were calculated as 47 and 3.5% for the single-day method, 82 and 4.7% for the 2-day method and 88 and 5.3% for the 3-day method, respectively. This detection rate was significantly different between the single- and the 2-day methods, as well as between the single- and the 3-day methods (P<0. 05). No significant differences in the false-positive rate amongst the three testing methods were observed. This analysis suggests that a 2-day faecal collection method is recommended for immunochemical occult blood screening by Monohaem from the aspects of cost-effectiveness and diagnostic accuracy.

Adult↗
PubMed1997

Fecal lactoferrin, fecal leukocytes and occult blood in the diagnostic approach to childhood invasive diarrhea.

OBJECTIVE: To compare fecal screening tests in the diagnostic approach to childhood invasive diarrhea. SETTING AND PATIENTS: We assessed 125 consecutive children with acute diarrhea for fecal lactoferrin, fecal leukocytes and occult blood from November, 1995, to June, 1996. RESULTS: Lactoferrin showed a greater overall sensitivity than fecal leukocytes or occult blood for detecting invasive pathogens. Combinations of lactoferrin or fecal leukocytes and of lactoferrin or occult blood or both yielded sensitivities and negative predictive values close to 100%, being superior to all other combinations. All patients with full breast-feeding and mixed feeding had a positive lactoferrin test with a 1:50 dilution used as the cutoff. In controls without diarrhea being exclusively bottle-fed, 3 of 15 (20%) still showed a positive lactoferrin result at the dilution of 1:50. This compared with 15 of 15 (100%) positive results among controls fully breast-fed, 14 of 15 (93%) among controls predominantly breast-fed and 11 of 15 (73%) among control children predominantly bottle-fed. CONCLUSIONS: This study confirms the usefulness of lactoferrin testing as a negative predictor. Breast-feeding lowers the specificity of the test but does not alter the sensitivity. Fecal lactoferrin may be viewed as the screening test of choice to avoid expensive stool cultures in the diagnostic approach to invasive diarrhea.

Child↗
PubMed1990

Results of a repeat television-advertised mass screening program for colorectal cancer using fecal occult blood tests.

The results of a 1987 television-advertised colorectal screening program using fecal occult blood tests (FOBT) are compared with the initial 1986 program (results in parentheses). In the 1987 program, 73,508 fecal occult blood test (FOBT) kits were distributed free of charge, of which 63% were returned for analysis (57,000, 53%). Twenty-five percent of persons from the initial screening participated again in the 1987 program: 1,303 or 2.8% of persons had a positive screen (1,165, 3.9%). The predictive value of a positive screen was 23% for an adenomatous polyp and 8% for colorectal cancer (22%, 8%). Seventy-nine percent of the cancers detected were Dukes A or B or carcinoma in situ (78%). In order to promote a more thorough diagnostic work-up in positive screenes, a suggested diagnostic algorithm for the work-up of a positive FOBT was sent to participating physicians. Despite this, 35% of positive screenees had a diagnostic work-up limited to a repeat FOBT, and/or sigmoidoscopy only (32%). In conclusion, television-advertised mass screening programs consistently enroll large numbers of participants. The rate of compliance (percent of kits returned) and the limited diagnostic evaluation of persons with a positive screen appear to be the major factors limiting the success of our screening program.

Adenocarcinoma↗
PubMed1981

[The occult blood reaction].

The faecal benzidine assay has been replaced during the last few years by a great number of different assays on occult blood in faeces. The causes of occult blood at children are different from adults. Which test should be used depends on the desired sensitivity of 2 à 3 mg haemoglobin/g faeces are most suitable to prevent false-positive and false-negative results. To reduce false-negative results it is recommended to perform the assay on three successive days.

Child↗
PubMed1996

Comparison of three faecal occult blood tests in the detection of colorectal neoplasia.

METHODS AND AIMS: For the detection of colorectal neoplasia, 192 consecutive patients had colonoscopy to evaluate the sensitivity and specificity of three faecal occult blood tests (FOBT). Of 160 evaluable patients (96 female, mean age 51.9), 21 patients (13.1%) had adenomas and three patients (1.9%) had colorectal carcinoma. RESULTS: When comparing all three faecal occult blood tests for the detection of colorectal neoplasia, the sensitivity of Monohaem (43.8%) was superior to both Hemoccult II (25%) and to BM-Test colon albumin (25%). The specificity of Monohaem (94.6%) was greater than both Hemoccult II (88%) and BM-Test colon albumin (89%). Using McNemar's test, Monohaem was a more accurate FOBT than Hemoccult II and BM-Test albumin (p < 0.05). In the 21 patients with adenomatous polyps, FOBT sensitivity seemed to be dependent on polyp size, but not polyp site. CONCLUSIONS: Monohaem, a feacal occult blood test that uses a monoclonal antibody that is specific for human haemoglobin, is a more accurate test in the detection of colorectal neoplasia and should possibly be used in colorectal cancer screening programmes.

Adenoma↗
PubMed2000

[Physicians' reminders promote annual fecal occult blood testing compliance].

Screening for the early detection of colorectal cancer using the fecal occult blood test has been shown to be effective in reducing mortality. In Israel family physicians recommend that their patients, aged 50-75, have the test performed annually. But compliance with testing in the general population has been poor. We therefore studied this issue in 3 primary care facilities, in 384 patients, average age 62.7 +/- 6.9 years; 81 (21.1%) performed the fecal occult blood test. Performance rates were significantly lower (13.9%) in those aged 50-59 (p = 0.0003), as compared with those aged 60-69 and 70-75 (24.3% and 24.7%, respectively). Compliance rates of the patients of different physicians varied as well. Recommendation of family physicians led to overall compliance of 21.1%. Additional efforts are needed to increase compliance in order to decrease colorectal cancer morbidity and mortality in Israel.

Aged↗
PubMed1990

[Evaluation of RPHA fecal occult blood test in screening for colorectal cancer].

Evaluation of reverse passive hemagglutination (RPHA) fecal occult blood (FOB) test in screening for colorectal cancer was carried out in a group of subjects (3034 persons) with history of rectal polyp and ulcer. All subjects were examined by 60 cm fiberoptic colonoscopy, RPHA and benzidine (BT) FOB tests. Among this high risk population, 10 cases of colorectal cancer and 1 case of rectal carcinoid were detected by colonoscopy and pathology. Regarding the findings under fiberoptic colonoscopy as a reference standard, the sensitivity of RPHA and BT in screening for colorectal cancer was 63.6% and 72.7%; the specificity was 81.9% and 61.7%; the general indicator--Youden index was 0.46 and 0.34, respectively. In 7 cases of colorectal cancer with both FOB tests positive, 5 (71%) had lesions in early stages (Dukes A and B). The results indicate that comparing with BT, RPHA has slightly lower sensitivity but higher specificity. RPHA fecal occult blood test could be used as preliminary screening for colorectal cancer.

Adenocarcinoma↗
PubMed1984

Screening for occult blood in selected patients. The potential for false-negatives.

Seventy-one patients presenting for elective hernia repair without gastrointestinal symptoms were screened for occult blood in their stools. All patients had stools negative for occult blood and were studied with proctosigmoidoscopy and barium enema. Polyps were found in 10% of the study population. The potential for missing polyps definitely exists if patients are selected for further studies only on the basis of tests for occult stool blood.

Barium Sulfate↗
PubMed1987

Mass screening for colorectal cancer by testing for occult blood under restricted diet and a questionnaire in Osaka.

Because of the recent increase in the incidence of colorectal cancer in Japan, attempts were made to find an effective method for screening asymptomatic patients with this cancer. A total of 12,520 participants in Osaka were screened in a 2-year program from April 1982 by a test of fecal occult blood under a restricted diet, and a medical questionnaire. Occult blood in feces was examined for 3 consecutive days using one guaiac-impregnated slide (Shionogi B) each day. This slide was about twice as sensitive as the Hemoccult slide. Further diagnostic workups were required in 3,452 individuals, of which 2,602 (75.7%) were due to positive occult blood. Proctosigmoidoscopy was performed in 2,214 (64.4%) of these persons, barium enema in 1,397 persons, and flexible colonoscopy in 187 persons. Colorectal cancers were detected in 18 patients (0.14% of the total screened); ten of these cancers were in an early stage. Thus this screening method is reliable for detecting asymptomatic cancer of the colon and rectum.

Colonic Neoplasms↗