Bowel cancer can develop without early warning signs or symptoms. The cancer can grow inside the bowel for many years before it is detected. Often, small amounts of blood can leak from these growths and pass into bowel motions.

What is a Faecal Occult Blood Test?

A Faecal Occult Blood Test (FOBT) can detect minimal amounts of blood in your bowel motions.

The test involves taking samples from two or three bowel motions using a test kit. The samples are collected from several motions, so any problem is more likely to be found. These samples are analysed at a pathology laboratory, and if blood is detected, further tests may be required.

There are currently two different types of FOBT available in Australia – guaiac and immunochemical. Guaiac tests require patients to alter their diet and medications, and require samples from three separate bowel motions. Immunochemical tests are generally more acceptable, as no change to the patient’s diet or medication is necessary, and samples are only required from two separate bowel motions.

Although FOBTs are not the most accurate diagnostic test for bowel cancer, they are currently the most well-researched screening test, and are the cheapest and most acceptable test available. An FOBT is also non-invasive, compared to colonoscopy and sigmoidoscopy.

Can anyone have an FOBT?

It is recommended that people with no family history or no symptoms of bowel cancer have an FOBT every two years from 50 years of age.

Some people may be at a greater risk of developing bowel cancer, including those with:

• Previous history of polyps in the bowel.
• Previous history of bowel cancer.
• Chronic inflammatory bowel disease (ie Crohn’s disease).
• A strong family history of bowel cancer.
• Familial adenomatous polyposis or hereditary non-polyposis colorectal cancer.
• Increased insulin levels or diabetes.

If you are at increased risk, you should discuss surveillance options with your doctor.

National Bowel Cancer Screening Program

The National Bowel Cancer Screening Program is a population-based screening program for bowel cancer that began in Australia in 2006. Currently the program is only offered to those people turning 50, 55 or 65 years of age between 1 January, 2008 and 31 December, 2010, and who hold a Medicare card or DVA gold card. The program uses the ’Detect’ immunochemical FOBT, produced by Bayer.

A test kit is sent in the mail to people eligible to participate in the program. The samples are collected in the privacy of the participant’s home, and are sent on to a pathologist for analysis. The results are sent to the participant and their GP. If the FOBT is positive, further tests are needed.

Where can I get an FOBT?

If you are not eligible or do not wish to participate in the program, you can still have an FOBT.

Your GP may provide you with a test kit, or can refer you to a pathology service, where the test will be carried out. In addition, some pharmacies also have test kits available for purchase. Test kits are available on the internet, however you should discuss the use of FOBT kits with your GP before purchasing such a kit.

What do my test results mean?

A negative test result means that no blood has been detected in the samples provided. This does not mean that you do not have or won’t develop bowel cancer in the future. Those with a negative result should test again in two years.

If your FOBT results are positive, this means blood has been detected in your sample. About one in 14 people will have a positive FOBT result.

Bleeding may be caused by a number of conditions, including polyps, haemorrhoids or inflammation, and may not necessarily be cancer related. However, the bleeding needs to be investigated and if blood is detected, you should contact your doctor to discuss the results and what further tests will be required.

Remember, if you have any concerns or questions, please contact your doctor.

Where can I get reliable information?

Cancer Council Helpline 13 11 20
Information and support for you and your family for the cost of a local call anywhere in Australia.

Cancer Council Australia website
(with links to state and territory Cancer Councils)
www.cancer.org.au  

National Bowel Cancer Screening Program
Information Line 1800 118 868
www.cancerscreening.gov.au