Fecal occult blood testing: comparative evaluation of a two-hole versus a three-hole single slide test

The aim of this study was to analyze the effectiveness of the three-hole fecal occult blood test hemoCARE in the detection of colorectal neoplasia in asymptomatic individuals in comparison with the conventional two-hole single slide test Hemoccult. Tests were distributed to 10,269 subjects older than 45 years. A total of 62.8% of the participants returned both tests, which were positive in 374 (5.8%). The diagnostic evaluation of 208 cases revealed 57 colorectal adenomas and carcinomas. The hemoCARE test was associated with a larger number of false-positive results than the Hemoccult test (p < 0.01). Fecal occult blood testing with the three-hole test demonstrated a significant increase in the yield of colorectal neoplasms as compared with the two-hole test (57 vs. 48 detected colorectal neoplasms; p < 0.01) without modifying the positive predictive value.