The correlation of symptoms, occult blood tests, and neoplasms in patients referred for double-contrast barium enema.

One hundred and forty-nine patients (86 women) with a mean age of 64 years (52-74 years), referred for double-contrast barium enema (DCE), were invited to have fecal occult blood test and rectosigmoidoscopy (60 cm) (RSS) before the DCE. Carbon dioxide was used for inflation at RSS to enable the two examinations to be done at the same time. Eight adenomas < 1.0 cm in diameter, 11 adenomas > or = 1.0 cm in diameter, and 5 carcinomas were diagnosed in altogether 23 patients. There was no correlation between symptoms, diverticula, or neoplasm, but a positive rehydrated Hemoccult II test was correlated to the presence of neoplasms (cancer and adenoma > or = 1.0 cm in diameter), but Hemoccult is not suitable as selection basis for work-up of symptomatic subjects. To diagnose colorectal neoplasms, we have to accept a certain number of negative work-ups of the large bowel. If DCE is chosen for work-up of the large bowel, it has to be combined with rectosigmoidoscopy (60 cm).