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

J Clin Pathol. 2013 Apr;66(4):330-4. doi: 10.1136/jclinpath-2011-200406. Epub 2013 Jan 2.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Barium Sulfate
  • Carcinoma / diagnosis*
  • Carcinoma / diagnostic imaging
  • Carcinoma / economics
  • Carcinoma / pathology
  • Child
  • Child, Preschool
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / economics
  • Colorectal Neoplasms / pathology
  • Contrast Media
  • England
  • Female
  • Health Care Costs
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mass Screening / economics
  • Mass Screening / methods*
  • Mass Screening / standards
  • Middle Aged
  • Occult Blood*
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Referral and Consultation* / economics
  • Referral and Consultation* / standards
  • Retrospective Studies
  • State Medicine* / economics
  • State Medicine* / standards
  • Time Factors
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Young Adult

Substances

  • Contrast Media
  • Barium Sulfate