Understanding your FOBT

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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. These are analysed at a pathology laboratory, and if blood is detected, further tests may be required.

There are currently two types of FOBT in Australia – guaiac and immunochemical. Guaiac tests require alterations to diet and medications, and samples from three separate bowel motions. Immunochemical tests do not require changes to diet or medication, and samples are only taken from two separate bowel motions.

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

Can anyone have an FOBT?

If you have no symptoms or family history of bowel cancer, an FOBT is recommended every two years from age 50.

Risk increases significantly after the age of 50. You are also at a greater risk if you have:

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 (Lynch syndrome)
increased insulin levels or diabetes.

If you are at increased risk, 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.

Currently the program, using FOBT, is currently offered free to people turning 50, 54, 58, 60, 62, 64, 66, 68, 70, 72 or 74 years of age. By 2020, all Australians aged 50 to 74 will be offered the test free every two years.

A test kit is mailed to people eligible for the program. Samples are collected in the privacy of your home and sent to a pathologist for analysis. Results are sent to you and your GP. If the FOBT is positive, further tests are needed.

For more information visit www.bowelcancer.org.au

Where can I get an FOBT?

Cancer Council recommends all Australians aged 50 and over screen for bowel cancer with a faecal occult blood test (FOBT) every two years.

If you are not eligible for a free test under the national screening program, you can still be tested. Contact your GP to discuss options. Your GP can request a Faecal Occult Blood Test, which is eligible for a Medicare benefit. Most pathology practices bulk bill for this test.

Other options:

Some pharmacies have FOBT kits available for purchase over the counter.
Some pathology services or health organisations provide online options for purchasing a kit.

You should discuss the use of FOBT kits with your GP before purchasing a kit.

For more information call Cancer Council Helpline 13 11 20.

What do my test results mean?

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.

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. If you have a negative result you should test again in two years.

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.