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Limitations of Fecal Occult Blood Testing

Arch Intern Med. 1990;150(5):945-946. doi:10.1001/archinte.1990.00390170007001.
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The medical literature is replete with studies of fecal occult blood tests, as documented in the references of the articles by Stelling et al1 and See also pp 1001 and 1041. Ahlquist et al2 in this issue of the Archives. Much of the assessment of fecal occult blood testing has been in the area of screening for colorectal carcinoma, a subject recently well reviewed.3,4 Ahlquist et al2 emphasize that even with the use of HemoQuant, a sensitive measure of gastrointestinal (GI) tract bleeding, 41% of patients with symptomatic colorectal cancers had a negative result of a fecal occult blood test. In relation to other tests, HemoQuant requires greater stool sampling. This study is limited by its retrospective nature and failure to define why 40 patients did not qualify. An interesting finding was significantly higher positivity when testing was performed before bowel preparation for diagnostic studies. The


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