The Significance of Fecal Occult Blood Testing to Screen for Colon Cancer

Kwon, Jung Hyun; Choi, Myung Gyu; Suh, Jung Pil; Chang, Jae Hyuck; Nam, Kwan Woo; Park, Ho Sung; Paik, Chang Nyol; Park, Jae Myung; Cho, Yu Kyung; Lee, In Seok; Kim, Sang Woo; Chung, In Sik

Abstract

BACKGROUND/AIMS: We investigated the efficacy of the fecal occult blood test (FOBT) as a colon cancer screening tool in a tertiary hospital setting.
METHODS
This retrospective study analyzed patients who underwent routine check-ups at Kang-Nam St. Mary's Hospital Health Promotion Center from January 2004 to April 2005. All the subjects were encouraged to submit stool for a FOBT, while performing a double contrast barium enema (DCBE) was optional for those who wanted colon examination. Colonoscopy was performed if the FOBT or DCBE results were abnormal or if the patients had bowel symptoms.
RESULTS
The FOBT was performed in 8,198 of 10,182 patients (80.5%) who underwent routine check-ups. The overall positive rate of FOBT was 149 of 8,198 (1.8%) and this increased with age (p<0.05). Colonoscopy and/or DCBE was performed in 33 of 149 patients (22.1%) in the FOBT positive group. Colon cancer and polyp were diagnosed 2 (6.1%) and 7 (21.2%) patients, respectively, in the FOBT positive group, whereas colon cancer and polyp were diagnosed in 3 (0.5%) and 102 (15.7%) patients, respectively, in the FOBT negative group. The sensitivity and specificity of the FOBT for colon cancer was 40% and 95.4%, respectively.
CONCLUSIONS
Although it had low sensitivity, the FOBT was a useful screening tool for detecting colon cancer in a tertiary hospital setting.