Position statement of Faecal Occult Blood [FOB] testing on Asymptomatic People.
The New Zealand Society of Gastroenterology considers that testing the faeces of patients who have no gastrointestinal symptoms, of any age, for signs of occult blood loss is inappropriate outside of a fully funded Bowel Cancer Screening Programme.
Even in symptomatic patients it is not a useful test, when appropriate specialist review and directed investigations are the correct approach.
A positive FOB (iFOB or ≥2 of 3 Guaiac FOB tests) is statistically linked to a slightly increased possibility of lower GI pathology, however use of FOB tests in the well population outside BCSP not only leads to raised anxiety in patients with no symptoms, but, if referred onto the public health system for colonoscopy or CT Colonography, places a pressure on an already stressed system, where many symptomatic patients are still having to wait beyond acceptable periods.
Dr Jonathan Coleman, Minister of Health, agrees with the withdrawal of FOB testing outside a centrally funded screening programme.
The New Zealand Society of Gastroenterology therefore asks Medical Laboratories to remove FOB testing from their list of investigations forthwith.