FOBT

What is the FOBT?

Bowel cancer may be present for many years before symptoms (weight loss, rectal bleeding, change in bowel habit or pain) develop. Often by the time these symptoms  arise, the cancer is no longer in its early stage. Non-visible bleeding (occult) may have been occurring in the pre-cancerous stages of bowel cancer.  This is the basis of the screening programme for bowel cancer.

Australians who turn 50, 55 or 65 years old between 1 July 2011 to 31 December 2014 will be invited to take part. The process involves receiving an invitation letter followed by the FOBT (faecal occult blood test).

There are no dietary restriction with the FOBT mailed out to you. Complete the test with three separate bowel motions, and return it by mail to the specified pathology service.

Results are sent both to the patient and their GP.

Is the FOBT all the testing I need?

The FOBT is the best screening tool for patients who have no symptoms (asymptomatic) and no family history of bowel polyps or bowel cancer.

FOBT is an insufficient screening test for bowel cancer where the risk for bowel cancer is greater than the normal population, such as:

  • Previous history of polyps in the bowel
  • Previous history of colon or rectal cancer
  • History of Ulcerative Colitis or Crohn’s Disease
  • A strong family history of bowel cancer
  • If you have FAP (familial adenomatous polyposis), HNPCC (hereditary non-polyposis colorectal cancer) or any other high risk familial colorectal cancer syndrome

If my FOBT test is positive, does that mean I have cancer?

The FOBT is not a diagnostic test, it is a screening tool to identify asymptomatic patients who have blood detected in their stool.

About 1 in 14 patients will have a positive FOBT.

Blood in the stool can be caused by a variety of causes unrelated to cancer, including haemorrhoids, colitis (inflammation), diverticulosis and angiodysplasia.

In population screening programs, a positive FOBT has

  • 30-45% chance of having a polyp
  • 3-10% chance of having a cancer*

From the available data, almost 80% of bowel cancers removed from the screening process were stage 1 or stage 2 cancers (earliest stage).

What happens after my positive FOBT?

The next most likely step is to organise a consultation with a Colorectal Surgeon and a colonoscopy.

Your GP can also refer you via our Direct Access Colonoscopy if appropriate (see For GP’s link above)

You can also get more information online or via the links tab above.

What happens after a negative FOBT?

If you remain free of symptoms, it is recommended that you repeat the FOBT every 2 years. If at any time however, you develop signs or symptoms such as

  • Visible rectal bleeding
  • Change in your bowel habit
  • Unexplained weight loss

you should see your GP as you may need a colonoscopy, irrespective of your negative test result.

National Bowel Cancer Screening Program

Information line 1800 118 868

www.cancerscreening.gov.au

 *NHMRC Guidelines – Clinical Practice Guidelines for the Prevention, Early detection and management of Colorectal Cancer