An evaluation of fecal occult blood screening in automated multiphasic health testing and services.

In the present paper, the efficacy of fecal occult blood screening in automated multiphasic health testing and services (AMHTS) is evaluated, and some problems with it are also discussed. A total of 54,735 subjects were screened for occult blood by the Shionogi slide 1-day method. According to a follow-up survey of the 715 subjects judged (+ +), 42 cases of colorectal polyp and 13 of colorectal cancer were confirmed. Eight of the 12 cases of primary colorectal cancer, excluding a case of metastatic transverse colon cancer, were located in the colon's right-side. The result may have arisen from the fact that most subjects in AMHTS are relatively young and free of symptoms. This suggests that fecal occult blood testing in AMHTS may be useful for detecting colon cancers of the right side as well as of the left. Of the nine cases of primary colorectal cancer previously screened, five had been judged (+) in previous testing. This fact indicates an especially rigorous examination of subjects judge (+) to be necessary in AMHTS. Meanwhile, of the 45 cases of gastric cancer detected by enhanced X-ray testing, only eight (17.8%) subjects were judged (+) or (+ +). It is suggested that fecal occult blood testing may not, therefore, be too effective in screening for gastric cancer.