What is meant by a 'strong family history of bowel cancer'?
What are the symptoms of bowel cancer?
What types of FOBT are available?
Why are two samples collected?
What do the test results mean?
How long will I have to wait for a colonoscopy?
An FOBT (faecal occult blood test) is a simple test that looks for the early signs of bowel cancer. It can be done at home and involves taking samples from 2 or 3 separate bowel motions (faeces) using a test kit. Samples are then sent to a laboratory for testing.
FOBTs look for tiny amounts of blood (that often can't be seen by the naked eye) in bowel motions. Blood is usually caused by something less serious than cancer. However, it may be a sign of an early bowel cancer or a polyp: a growth on the inside of the bowel that could develop into cancer. If the FOBT finds blood, further tests are needed to find out what's caused the bleeding.
People aged over 50, without symptoms and without a strong family history of bowel cancer, are encouraged to do an FOBT every 2 years. Those with a strong family history of bowel cancer or any symptoms should see a doctor.
A strong family history of bowel cancer refers to people who have had:
More than 75% of bowel cancer cases are not linked to a family history of bowel cancer, but if you think you have a family history of bowel cancer, talk to your doctor.
Although many bowel cancers grow without symptoms, there are a few things to look out for, including:
If you have one of these symptoms see your doctor.
If you're turning 50, 55 or 65 between 1 January 2008 and 31 December 2010, the Australian Government will send you a free FOBT as part of the National Bowel Cancer Screening Program.
More information about the National Bowel Cancer Screening Program
As Medicare rebates are not available for screening tests, those interested in bowel cancer screening but not yet eligible for the National Bowel Cancer Screening Program, will need to pay for an FOBT.
Options:
1. Order an FOBT online or call our Cancer Council Helpline on 13 11 20.2. Many GPs can provide FOBTs that can be completed at home and sent to a laboratory for analysis, with payment.
3. The Bayer Detect FOBT, being used in the National Program, is not currently commercially available but may be in the future.
4. Some pharmacies sell FOBTs.
5. Rotary has been running a Bowel Scan Program for several years, selling FOBTs through selected pharmacies.
6. Some health insurance funds provide FOBTs to their clients.
There are several different types of tests available, all of which involve collecting tiny samples from bowel motions. There are 2 main kinds of tests – guaiac tests and immunochemical tests. Guaiac tests require people to change their diets and stop taking some kinds of medication before the test. However, with immunochemical tests, there's no need to change diets or medication. An immunochemical test is being used for the National Bowel Cancer Screening Program.
Having 2 samples checked, rather than just 1, means any problem is more likely to be found.
Although no screening test is 100% accurate, the FOBT is currently the most widely available and well trialled screening test for bowel cancer. If you do an FOBT every 2 years, you can reduce your risk of dying from bowel cancer by up to one third.
Negative FOBTs do not mean that you do not have, or can never develop, bowel cancer. This is because some bowel cancers may not bleed, or may only bleed every now and then. If you receive a negative FOBT result, it's recommended that you continue to have FOBTs every 2 years.
It is also recommended that you see your doctor if you notice any sign of blood in your bowel motions or have any symptoms of bowel cancer.
There could be several reasons for finding blood in a bowel motion that may not be related to bowel cancer, for example, bleeding from piles, menstrual blood, etc.
However, if blood is found, it is important to speak to your doctor. Your doctor will talk with you about follow-up tests (such as colonoscopies) which check for bowel cancer, polyps or other causes of the positive FOBT result.
Remember, bowel cancer is 90% curable if found at an early stage.
A colonoscopy is a test that allows a specialist to look at the inside of the bowel. It is a day procedure. The test itself takes 20–30 minutes and is usually done in a hospital or day clinic.
The day before the colonoscopy you will be asked to drink a special preparation to help empty the bowel. On the day of the procedure you may be given medicine that will make you feel drowsy, so it is important that you do not drive home after the test.
The specialist will insert a narrow, flexible tube called a colonoscope into your back passage. The colonoscope allows the specialist to look for polyps or bowel cancers. Most polyps can be removed during the colonoscopy.
If you need to have a colonoscopy your doctor will explain the procedure and tell you about any risks. It is rare for a colonoscopy to cause serious problems.
Public hospital patients often have to wait several weeks, or sometimes months for the procedure. Private patients usually have a shorter wait.
For more information contact the Cancer Council Helpline on 13 11 20.
Updated June 2007
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Bowel cancer screening video (Length 1:22)
with Professor David Hill
