Experience with a wipe guaiac-based faecal occult blood test as an alternative test in a bowel screening programme.
The format of the traditional guaiac faecal occult blood test (gFOBT), particularly the collection technique, might cause difficulties for some. A multistage evaluation of alternative tests was performed. Firstly, four tests with different faecal collection approaches were assessed: a focus group recommended further investigation of a wipe gFOBT. Secondly, 100 faecal samples were analysed using two wipe tests and the routine gFOBT: no differences were found. Thirdly, a wipe gFOBT was introduced. Over 21 months, 400 requests were made and 311 wipe kit sets were submitted for analysis: 153 (49.2%) were negative, 21 (6.8%) positive (all 3 kits positive), 96 (30.9%) weak positive (1 or 2 positive) and 41 (13.2%) un-testable. Forty-three participants were referred for colonoscopy. Outcome data were provided on 39 participants: nine declined colonoscopy, two were judged unsuitable, two did not attend, two were already in follow-up, 13 had normal colonoscopy and two normal barium enema, two had diverticular disease, two had a metaplastic polyp, four had a low-risk adenoma and one had a high-risk adenoma. No participant had cancer. Detection of significant neoplasia was small. The use of the wipe gFOBT was ceased: it cannot be recommended as a screening test for bowel cancer.
Scottish Bowel Screening Centre Laboratory, Kings Cross, Dundee DD3 8EA, Scotland, UK. callum.fraser@nhs.net
C G
CG
Fraser
P J
PJ
McDonald
L
L
Colford
A
A
Irvine
M
M
Kenicer
C
C
Morton
J
J
Birrell
R J C
RJ
Steele
D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009780:Occult Blood