Hemoccult Test (Stool Test)

How is it used?

The main use for the hemoccult test (the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT)) is as a screen for early colon cancer. Most cases of colon cancer begin with the development of benign intestinal polyps. Benign polyps are relatively common in people over the age of 50. Most are harmless, but some can become cancerous.

This test is part of Cardio-Med's complete physical exam.

Blood in the stool may be the only symptom of early cancer; thus, if detected early, treatment can begin immediately, improving the chance of a cure.

The types of hemoccult test (stool test) are::

A secondary use of FOBT is to determine the cause of anemia, such as blood loss from a bleeding ulcer. If someone has signs and symptoms of anemia, such as fatigue, a low hemoglobin and hematocrit or unusually dark stools, your physician may order the FOBT.

When is it ordered?

The American Cancer Society (ACS) and other major healthcare organizations recommend a yearly stool test when a person chooses fecal occult blood testing as the method of screening for colon cancer. The ACS and others advise that screening for colon cancer begin at age 50 for the general population, but it may begin at an earlier age when a person has a family medical history of colon cancer.

Your physician may sometimes order an FOBT when someone has unexplained anemia that might be caused by bleeding in the digestive tract.

What does the hemoccult test result mean?

The fecal occult blood test is normally negative.

For the guaiac-based FOBT, a positive test result indicates that abnormal bleeding is occurring somewhere in the digestive tract. This blood loss could be due to ulcers, diverticulosis, polyps, inflammatory bowel disease, hemorrhoids, blood swallowed due to bleeding gums or nosebleeds, or benign or cancerous tumors.

For the fecal immunochemical test (FIT), a positive result indicates abnormal bleeding in the lower digestive tract. Since this test detects only human hemoglobin, other sources of blood, such as from the diet, do not cause a positive result. Moreover, hemoglobin from bleeding in the upper digestive tract is broken down before it reaches the lower digestive tract and is not detected by the FIT. Thus, the FIT is a more specific test than gFOBT.

A positive result from either the guaiac-based FOBT or immunochemical FIT requires follow-up testing. This usually involves direct imaging of the colon and rectum (sigmoidoscopy or colonoscopy).

Is there anything else I should know?

Bleeding, especially from polyps and tumors, is intermittent, so blood is not uniformly distributed in all stool samples. Taking three different samples on three different days increases the chances of detecting bleeding that is intermittent.

Other than stool tests, are there other ways of screening for colon cancer?

Yes. There are imaging tests that may be used to prevent and/or screen for colon cancer. One of these procedures may be chosen instead of screening annually with a hemoccult test:

Is the over-the-counter (OTC) at-home test just as good as other stool tests?

While the OTC tests that are dropped into the toilet are fairly sensitive, your physician may prefer the gFOBT or FIT. The color change that is observed in OTC tests is subject to interpretation by the patient. Laboratory professionals are more experienced than most people in interpreting the sometimes subtle color change and are more familiar with sources of false-negative and false-positive results.

What kind of procedures might follow a positive FOBT or FIT?

An FOBT or FIT may be preceded or followed by a digital rectal exam to detect any growths that may be present in the rectum. A positive FOBT or FIT may be followed by sigmoidoscopy or colonoscopy, which enables a gastroenterologist to see inside the colon and identify polyps or other abnormalities (see Question 1).

Are there any other types of tests for colorectal cancer that are run on stool samples?

Yes. There is a stool DNA (sDNA) test available. The test can detect certain alterations to DNA (genetic material) in cancer cells that are shed into the stool. Studies have shown that the test has acceptable sensitivity, although it cannot identify all types of colorectal cancer. Guidelines released in March 2008 jointly by the American Cancer Society, the American College of Radiology, and the US Multi-Society Task Force on Colorectal Cancer added sDNA to their list of recommended testing options for colorectal cancer screening. The American Cancer Society recommends that if this test method is used, it should be repeated every 3 years.

We also offer a body scan that provides ultrasound imaging of body organs and a test for stroke to check carotid artery blood flow to the brain. This suite of tests including the complete physical exam gives your physician a complete view of your state of health.


Call (847)758-1230 today for an appointment and consultation with our physician.
Serving Chicago, IL and all of the Chicago northwest suburbs, southeastern Wisconsin and northwestern Indiana.


Adapted from the American Association for Clinical Chemistry

cPhysical Exam - Level I includes:

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Detailed blood pressure evaluation in both arms (seated) and in right arm (recumbent or lying down)      More . . .
Thyroid function profile      More . . .
Resting 12-lead Electrocardiogram (ECG/EKG) recording of electrical activity of the heart      More . . .
Cholesterol/
triglycerides profile      More . . .
Detailed clinical evaluation and consultation by Physician, not Nurse      More . . .
Comprehensive chemistry profile      More . . .