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Fecal Occult Blood Test - FOBT
Introduction
A fecal occult blood test is used to screen patients for colorectal cancer. The test helps
detect the presence of hidden blood in the stool, which is one of the first warning signs
that a patient may have colorectal cancer.
Your doctor may ask you to have a fecal occult
blood test, or FOBT. This reference summary
explains why the test may be performed, how it is
performed, and how its results are interpreted.
Colorectal Cancer
The FOBT is most often used to screen patients for
colon cancer. This section gives you some
information about the disease.
Cancer that occurs in the colon or rectum is called colorectal
cancer. The colon is the large intestine; the rectum is the end of
the digestive tract from where stool is excreted through the anus.
Colorectal cancer is the fourth leading cause of cancer-related
death in the world.
The earlier colorectal cancer is detected, the more successfully it
can be treated.
Polyps and cancers tend to grow slowly and may bleed from time
to time (Polyp is a mass of tissue projecting outside the inner
membrane of the digestive tract. It is like a small grape in shape).
Sometimes this blood is visible in a patient’s stool; other times it
is not. Hidden blood in the patient’s stool can often be detected
by a screening test like FOBT, which may give a warning sign
regarding potential colorectal cancer.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 11/08/2015
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Fecal means stool, occult means not seen by the naked eye. Therefore, a fecal occult
blood test, or FOBT, detects blood in the stool that cannot be seen by the naked eye. If
an FOBT detects blood, however, this does not necessarily mean you have colorectal
cancer. Many factors can cause blood in the stool. Your doctor will order additional
tests to diagnose the cause of the bleeding.
How to Prepare
Because colon cancers may bleed only from time to time, the FOBT tests three
separate bowel movements over a period of several days. This increases the chance
of detecting small amounts of blood in your stool.
Some foods can cause the results of FOBT to be
a “false positive,” which means it appears that
there is blood in the patient’s stool even though
there is no blood in the stool. You need to avoid
these foods 2 to 3 days before the test: turnips,
beets, radishes, horseradish, artichokes,
mushrooms, broccoli, bean sprouts, cauliflower,
apples, oranges, bananas, grapes and melon.
The blood in red meat may also cause blood to appear in a patient’s stool. Therefore,
you should avoid red meat 2 to 3 days before the test.
Iron supplements, aspirin, and Vitamin C can also affect the results. Avoid them before
the test.
Your doctor may ask you to stop some medications that could affect the FOBT test
results. These include colchicine, iodine, antacids or boric acid.
If you have your menstrual period or have bleeding hemorrhoids, do not take the
FOBT.
How it is Done
The fecal occult blood test (FOBT) is one type of colorectal screening test. The test
can be conducted in a doctor’s office or at the patient’s home. A small sample of stool
is placed on a chemically treated card, pad, or wipe; then a chemical developer
solution is put on top of the sample. If the card, pad, or cloth turns blue, there is blood
in the stool.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 11/18/2015
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The procedure for testing blood in the stool varies depending on which type of home
test you have. It is important to follow the manufacturer's instructions provided with its
test. Always check the expiration date on the package. Read the instructions that come
with your test carefully and follow the directions exactly. For most tests, you will use
stool samples from three different bowel movements over three different days. It can
be unpleasant to collect a stool sample. However, the test has no risk and is an
effective way to screen for cancer.
Note: Products that are used to clean or deodorize the toilet
may contaminate the FOBT testing kit. Repeat the test if the
stool sample card touches the toilet seat or other objects
that have such chemicals.
Results
If the card turns blue, this means there may be blood in you
stool. This is called a positive test, or abnormal results.
If the card does not turn blue, this means no blood was detected in your stool. This is
called a negative test, or normal results.
If your FOBT results are abnormal or the test is positive, your doctor will order followup tests to check for the causes of bleeding, if any bleeding is confirmed. Follow-up
tests may include colonoscopy, upper GI endoscopy or sigmoidoscopy.
• Colonoscopy is the examination of the colon with an endoscope. The endoscope
is a long thin tube topped with a camera that allows the doctor to see inside the
colon.
• Endoscopy is the examination of the upper digestive system with an endoscope.
The endoscope is a long thin tube topped with a camera that allows the doctor to
see inside the colon.
• Sigmoidoscopy is the examination of the last part of the large colon with a scope.
The scope allows the doctor to see inside the colon.
If the FOBT is positive and additional testing does not find blood in the stool, this
means the original test was incorrect, or a “false positive.” Because many foods and
medicines affect FOBT results, don’t be anxious yet if you have a positive FOBT. Wait
for follow-up testing to confirm it was a “true positive.” The test may have been affected
by another condition, or food you ate.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 11/18/2015
ge2001030i
3
If the FOBT is positive and additional testing confirms blood in the stool, this means the
original test was correct, or a “true positive.” This still does not mean the patient has
cancer. In fact, the majority of patients who have a “true positive”
FOBT have bleeding in the digestive system that is not caused by
cancer.
If the FOBT is negative but later on other tests find blood in the stool,
this means the original test was a “false negative.” Because early
colorectal cancer does not bleed all the time and some colon cancers
do not bleed, an FOBT may be negative when the patient actually
has cancer. That is why your doctor may recommend repeated
testing over time.
Conclusion
A fecal occult blood test is a screening test that helps to detect the presence of hidden
blood in the stool. It is mostly used to screen for colorectal cancer. The test can be
performed at home. If the card on which the stool sample is placed turns blue, the
FOBT is positive, which means traces of blood were found in the stool.
If an FOBT detects blood in your stool, contact your healthcare provider; you may need
additional tests, such as a colonoscopy, upper GI endoscopy or sigmoidoscopy, to
confirm the bleeding and find its cause.
In most cases, the bleeding is caused by
medical conditions other than cancer. The
FOBT screens for colorectal cancer but does
not diagnose it.
Many foods and medications can affect an
FOBT, causing it to be positive. Prepare for the
FOBT test by halting the consumption of such
foods and medications.
The earlier we detect colorectal cancer, the more successfully we can treat it. Regular
FOBT screening saves lives. Your doctor can recommend how frequently you should
have the test, which depends on your age and your risk factors.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 11/18/2015
ge2001030i
4