UTILITY OF FAECAL OCCULT BLOOD TEST (FOBT) OUT OF COLORECTAL CANCER SCREENING PROGRAMME

Aims:

Colorectal cancer screening (CRC) programmes with (FOBT) in asymptomatic patients between 50 and 69 years old have demonstrated to be effective in terms of reduction of incidence and mortality. There is very few information about the utility of this tests out of screening programmes. We aim to analyse the endoscopic findings in patients with positive FOBT out of screening programme.

Methods:

We designed a retrospective study to investigate the endoscopic findings of patients with positive FOBT out of the screening programme between January and December 2015. The FOBT was performed in symptomatic patients (e.g: abdominal pain, constipation and diarrhoea). We compared these patients with two other groups: 1) First round population screening programme patients aged 60 – 69 from the same health area and 2) Symptomatic patients who underwent their first colonoscopy between March 2012 and July 2013 without a previous FOBT.

Results:

There were a total of 3217 FOBTs carried out in patients out of population screening programme. 630 patients had positive FOBT, with 332 of the undergoing a colonoscopy. CRC (15.1 vs. 6.4%; p < 0,0001) and advanced adenomas (35.8 vs. 9.5%, p < 0.0001) were more frequently found in patients with positive FOBT than in symptomatic patients who have not been through the faecal test. These finding are very similar to those found in the screening group with a slightly lower proportion of adenomas (51.5 vs. 68.9%), although there was a higher proportion of colorectal cancer in the FOBT+ group (15.1 vs. 8%). We compared both symptomatic and FOBT+ patients stratified by age under and over 65 obtaining similar results.

Conclusions:

The presence of a positive FOBT out of the CRC screening programmes is a valuable instrument for the detection of adenomas and neoplasia. It can be useful at the time of optimizing the waiting list for endoscopy in those symptomatic patients.