Does use of the Coloscreen Self-Test improve patient compliance with fecal occult blood screening?

Occult blood-screening methods which do not require stool manipulation have been devised in an attempt to improve patient compliance with fecal occult blood testing. We performed a randomized, prospective study comparing patient compliance with the Coloscreen Self Test, a fecal occult blood detection method which does not require stool manipulation, and standard guaiac-impregnated cards in a VA clinic and a university-based private practice to determine whether the Coloscreen Self-Test would improve patient compliance with fecal occult blood testing. Overall, there was no significant difference in compliance between the two tests, with a compliance of 71% (105/147) for the guaiac cards and 60% (88/136) for the Coloscreen Self-Test (p = 0.49). However, multiple logistic regression showed that, when using the Coloscreen Self-Test, patients at the VA clinic had significantly reduced compliance. Only 46% (23/50) returned the Coloscreen Self-Test compared with 84% (42/50) who returned the guaiac cards (p < 0.05). We conclude that the Coloscreen Self-Test does not improve patient compliance with fecal occult blood testing, and may reduce compliance in some sectors of the population.