The clinical value of Haemoccult and Fecatwin in the detection of colorectal neoplasia in hospital and general practice patients

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Abstract
Asymptomatic general practice patients (450) and 330 hospital inpatients had their stools tested for occult blood with the Haemoccult and Fecatwin methods. In general practice, 9/64 (14%) of patients with a positive result had a colonic neoplasm (3 carcinomas, 1 Dukes'' Stage A, 2 Dukes'' Stage C, 6 adenomas) and in hospital 12/142 patients (8%) were found to have colonic tumors, (9 carcinomas, 2 Dukes'' Stage A, 2 Dukes'' Stage B;, 5 Dukes'' Stage C and 3 adenomas). The overall detection rates for colonic neoplasia were 2% in general practice and 3.4 in hospital. In 2 yr of follow-up, none of the general practice patients have presented with colonic symptoms. Two hospital patients with colonic carcinomas produced negative tests with blood methods. Out of the total of 21 colonic neoplasms, 9 were detected by Fecatwin alone, but this trend in favor of the more sensitive test did not reach the 5% level of statistical significance. In contrast, the number of false positive results were significantly greater with Fecatwin than Haemoccult. The Fecatwin method apparently warrants assessment in a full controlled trial of its value as a population screening test for colonic cancer.