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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.”