Fecal Test Offers Some Patients Alternative to Colonoscopy | Vital Signs | UCLA Health

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ga s t ro e n t e ro lo g y Fecal Test Offers Some Patients Alternative to Colonoscopy For individuals who can’t undergo a routine colonoscopy, the simple fecal occult blood test (FOBT) is recommended to reduce the risk of mortality from the second-leading cancer killer in the United States. Regular colonoscopy screening saves lives by detecting and removing benign polyps that can lead to colorectal cancer, or by detecting the cancer at an early, treatable stage. But for individuals who can’t or won’t undergo a routine colonoscopy, the simple fecal occult blood test (FOBT) — a laboratory test that checks stool samples for hidden blood — is recommended to reduce the risk of mortality from the second-leading cancer killer in the United States. “FOBT is not the preferred means by which to screen patients, and isn’t needed for people who are following colonoscopy- screening recommendations,” says UCLA gastroenterologist Bennett Roth, MD. “But at best, only 55-to-60 percent of the population is adhering to those recommendations. Those who aren’t should, at least, consider having an annual FOBT, which, if positive, would be stronger evidence for the need for colonoscopy.” For the FOBT, patients send stool samples to a laboratory to test for occult, or hidden, blood that would not be detectable by the naked eye and that could indicate the presence of benign polyps or cancer. If blood is detected, patients undergo a colonoscopy. Traditionally, the FOBT has used a substance called guaiac to detect occult blood, but a newer type of FOBT, fecal immunochemical testing (FIT), is far superior, Dr. Roth says. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) The FIT test is also more convenient than the guaiac-based FOBT in that it generally requires collecting and mailing one sample rather than three, and doesn’t require avoiding particular foods or medications. But despite becoming the FOBT test of choice, FIT is not nearly as effective at detecting and preventing colorectal cancer as colonoscopy screening and shouldn’t be seen as a substitute, Dr. Roth says. For patients at average risk, that generally means getting an initial colonoscopy at age 50 and then once every 10 years until the age of 75 or 80, assuming the results are negative. Those who have had a first-degree relative diagnosed with colon cancer are advised to start at 40 (earlier if the relative’s disease was diagnosed before age 50). For anyone getting a colonoscopy, if polyps are found during the exam, a three-to-five-year follow-up is recommended. Studies have shown that colonoscopy screening reduces the likelihood of colorectal cancer by up to 75 percent and the risk of colorectal cancer death by 50-to-60 percent. “Rather than only testing for occult blood, a later finding in colon disease, during a colonoscopy we can directly visualize the colon wall, identify abnormalities and preemptively remove polyps that could progress into cancer,” says Sandra Vizireanu, MD, a UCLA family physician in Redondo Beach. “For patients who are not getting a colonoscopy, the FOBT is considerably better than no screening at all. However, for detecting precancerous polyps and preventing cancer, a colonoscopy is the gold standard.” ga s t ro e n t e ro lo g y Fecal Test Offers Some Patients Alternative to Colonoscopy anyone getting a colonoscopy, if polyps are found during the exam, a three-to-five-year For individuals who can’t undergo a routine colonoscopy, the simple follow-up is recommended. fecal occult blood test (FOBT) is recommended to reduce the risk of Studies have shown that colonoscopy mortality from the second-leading cancer killer in the United States. screening reduces the likelihood of colorectal cancer by up to 75 percent and the risk of colorectal cancer death by 50-to-60 percent. “Rather than only testing for occult blood, Regular colonoscopy screening saves lives by The FIT test is also more convenient than a later finding in colon disease, during a detecting and removing benign polyps that the guaiac-based FOBT in that it generally colonoscopy we can directly visualize the can lead to colorectal cancer, or by detecting requires collecting and mailing one sample colon wall, identify abnormalities and the cancer at an early, treatable stage. But rather than three, and doesn’t require preemptively remove polyps that could for individuals who can’t or won’t undergo a avoiding particular foods or medications. progress into cancer,” says Sandra Vizireanu, routine colonoscopy, the simple fecal occult MD, a UCLA family physician in Redondo But despite becoming the FOBT test of choice, blood test (FOBT) — a laboratory test that Beach. “For patients who are not getting FIT is not nearly as effective at detecting and checks stool samples for hidden blood — is a colonoscopy, the FOBT is considerably preventing colorectal cancer as colonoscopy recommended to reduce the risk of mortality better than no screening at all. However, for screening and shouldn’t be seen as a substitute, from the second-leading cancer killer in the detecting precancerous polyps and preventing Dr. Roth says. For patients at average risk, that United States. cancer, a colonoscopy is the generally means getting an initial colonoscopy “FOBT is not the preferred means by which at age 50 and then once every 10 years until gold standard.” to screen patients, and isn’t needed for the age of 75 or 80, assuming the results are people who are following colonoscopy- negative. Those who have had a first-degree screening recommendations,” says UCLA relative diagnosed with colon cancer are gastroenterologist Bennett Roth, MD. “But at advised to start at 40 (earlier if the relative’s best, only 55-to-60 percent of the population disease was diagnosed before age 50). For is adhering to those recommendations. Those who aren’t should, at least, consider having an annual FOBT, which, if positive, would be stronger evidence for the need for colonoscopy.” For the FOBT, patients send stool samples to a laboratory to test for occult, or hidden, blood that would not be detectable by the naked eye and that could indicate the presence of benign polyps or cancer. If blood is detected, patients undergo a colonoscopy. Traditionally, the FOBT has used a substance called guaiac to detect occult blood, but a newer type of FOBT, fecal immunochemical testing (FIT), is far superior, Dr. Roth says. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) ga s t ro e n t e ro lo g y Fecal Test Offers Some Patients Alternative to Colonoscopy For individuals who can’t undergo a routine colonoscopy, the simple fecal occult blood test (FOBT) is recommended to reduce the risk of mortality from the second-leading cancer killer in the United States. Regular colonoscopy screening saves lives by detecting and removing benign polyps that can lead to colorectal cancer, or by detecting the cancer at an early, treatable stage. But for individuals who can’t or won’t undergo a routine colonoscopy, the simple fecal occult blood test (FOBT) — a laboratory test that checks stool samples for hidden blood — is recommended to reduce the risk of mortality from the second-leading cancer killer in the United States. “FOBT is not the preferred means by which to screen patients, and isn’t needed for people who are following colonoscopy- screening recommendations,” says UCLA gastroenterologist Bennett Roth, MD. “But at best, only 55-to-60 percent of the population is adhering to those recommendations. Those who aren’t should, at least, consider having an annual FOBT, which, if positive, would be stronger evidence for the need for colonoscopy.” For the FOBT, patients send stool samples to a laboratory to test for occult, or hidden, blood that would not be detectable by the naked eye and that could indicate the presence of benign polyps or cancer. If blood is detected, patients undergo a colonoscopy. Traditionally, the FOBT has used a substance called guaiac to detect occult blood, but a newer type of FOBT, fecal immunochemical testing (FIT), is far superior, Dr. Roth says. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) The FIT test is also more convenient than the guaiac-based FOBT in that it generally requires collecting and mailing one sample rather than three, and doesn’t require avoiding particular foods or medications. But despite becoming the FOBT test of choice, FIT is not nearly as effective at detecting and preventing colorectal cancer as colonoscopy screening and shouldn’t be seen as a substitute, Dr. Roth says. For patients at average risk, that generally means getting an initial colonoscopy at age 50 and then once every 10 years until the age of 75 or 80, assuming the results are negative. Those who have had a first-degree relative diagnosed with colon cancer are advised to start at 40 (earlier if the relative’s disease was diagnosed before age 50). For anyone getting a colonoscopy, if polyps are found during the exam, a three-to-five-year follow-up is recommended. Studies have shown that colonoscopy screening reduces the likelihood of colorectal cancer by up to 75 percent and the risk of colorectal cancer death by 50-to-60 percent. “Rather than only testing for occult blood, a later finding in colon disease, during a colonoscopy we can directly visualize the colon wall, identify abnormalities and preemptively remove polyps that could progress into cancer,” says Sandra Vizireanu, MD, a UCLA family physician in Redondo Beach. “For patients who are not getting a colonoscopy, the FOBT is considerably better than no screening at all. However, for detecting precancerous polyps and preventing cancer, a colonoscopy is the gold standard.”