J Clin Pathol doi:10.1136/jclinpath-2011-200406
  • Original article

Outcomes of faecal occult blood tests requested outside the UK National Bowel Cancer Screening Programme

  1. Christopher Harmston1
  1. 1Department of Colorectal Surgery, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
  2. 2Department of Biochemistry, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
  1. Correspondence to Christopher Harmston, Department of Colorectal Surgery, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry, Warwickshire CV2 2DX, UK; harmstonchris{at}
  • Received 31 December 2011
  • Revised 1 November 2012
  • Accepted 27 November 2012
  • Published Online First 2 January 2013


Background and aims Faecal occult blood test (FOBt) is commonly requested by clinicians in both primary and secondary care. The aim of this study was to examine the use and outcomes of clinician-requested FOB testing in a single Trust taking part in the National Bowel Cancer Screening Programme pilots.

Methods Data from a single Trust was used. The Trust's pathology reporting system was searched retrospectively for all FOBt study requests in 1 year. In patients with a positive test, the Trust's clinical results reporting system was searched to determine the type and outcome of any investigations. Patients with positive tests were cross-matched with the Trust's colorectal cancer database to detect interval cancers.

Results 1363 FOB tests were requested during the calendar year. 715 (52.5%) were completed. Mean age was 60.6 years, 30.7% of patients were in the screening age group. 60 (4.4%) patients were FOBt positive. Total colonic imaging was performed in only 22% of those who were FOBt positive. Significant pathology was detected in five patients (0.4%) including three colonic carcinomas. There were no interval cancers in the FOBt-positive group.

Conclusions The number of FOBt requests has increased with the introduction of a colorectal cancer screening programme. The FOBt completion rate and colonic imaging rate in FOBt-positive patients outside the national screening programme was low. Guidelines for the use of FOBt outside of screening are needed.

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