The diagnostic value of the hemoccult as a screening test in patients taking anticoagulants

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Abstract
The value of a 3-day Hemoccult II test in the diagnosis of colorectal disease in 849 patients receiving anticoagulant therapy was studied. The influence of rehydration and nonrehydration of the slide was investigated, as was the reproducibility of positive tests. Patients on anticoagulant therapy performed 3 Hemocult II tests each. There were 128 (15%) who had .gtoreq. 1 positive slides when these were rehydrated. Three patients with carcinoma and 13 patients with adenomas were found among these 128 patients. Of these patients, 121 performed 6 duplicate Hemoccult II tests with 4 samples from each of 3 consecutive stools. Three of the 6 slides were rehydrated and 3 were not rehydrated before development; 41 and 23 patients, respectively, showed positive test results. Two of 3 reinvestigated patients with large bowel carcinoma had positive slides in both of these series. Seven and 2, respectively, of 13 patients with adenomas had positive tests in the 2nd series when the slides were developed with and without rehydration. Thus, the predictive value was low with nonrehydrated slides, and the precision was low when the slides were rehydrated. Evidently, the sensitivity of a 3-day Hemoccult II test without rehydration is too low to permit its use as a screening method for colorectal neopolasms in patients receiving anticoagulant therapy.