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[Endoscopic diagnoses in patients with positive Hemoccult-test: critical consideration and negative Hemoccult-test
Insights
The Hemoccult test is not reliable for detecting colorectal cancer or polyps, especially in patients with symptoms. A negative test result does not rule out the presence of a large bowel tumor.
Area of Science:
- Gastroenterology
- Oncology
- Medical Diagnostics
Context:
- The Hemoccult test is a common screening tool for colorectal cancer.
- Clinical signs are often present in patients with colorectal tumors.
- Coloscopy is a definitive diagnostic method for large bowel pathologies.
Purpose:
- To evaluate the diagnostic accuracy of the Hemoccult test compared to coloscopy.
- To determine the rate of false-negative results for the Hemoccult test.
- To assess the utility of the Hemoccult test in symptomatic patients.
Summary:
- 170 patients were analyzed, with 29 testing positive and 141 negative via Hemoccult test.
- Coloscopy revealed a 29.0% false-negative rate for the Hemoccult test.
- False negatives included 5.6% of carcinomas and 23.4% of polyps, with most patients presenting clinical signs.
Impact:
- Highlights limitations of the Hemoccult test in colorectal cancer screening.
- Suggests Hemoccult test is best suited for asymptomatic individuals.
- Emphasizes that a negative Hemoccult test does not exclude large bowel tumors, necessitating further investigation if clinical suspicion exists.
Abstract:
Totally 170 patients with positive (n = 29) and with negative Hemoccult-test (n = 141) were examined by coloscopy. There were 29.0% false-negative Hemoccult-test results (carcinomas 5.6%, polyps 23.4%). Almost all patients with a endoscopically diagnosed carcinoma or polyp of the large bowel had clinical signs. It is concluded, that the Hemoccult-test is indicated only in patients, who do not show clinical symptoms, and that a negative Hemoccult-test result does not exclude a tumor of the large bowel.