Fecal occult blood testing for colorectal cancer in an ethnically diverse population

Fecal occult blood test kits were distributed throughout the ethnically diverse Hawaiian Islands during a 3-week period in 1989. Occult blood was detected in 1,631 persons (11.8%). At least 83% of the participants with positive tests sought medical advice. Subsequently, 76 (4.7%) were diagnosed as having colorectal adenomas and an additional 1.4% had malignant neoplasms (3 gastric and 20 colorectal adenocarcinomas). Three quarters of the colorectal cancers were localized and node-negative. Participation in this program and the type of diagnostic studies done on participants with positive tests varied according to sex and ethnicity. Therefore, these demographic variables must be considered in designing fecal occult blood screening programs.