Your FOBT questions answered

Invitees of the National Bowel Cancer Screening Program will be sent an invitation pack to their current postal address. The pack contains:

• invitation letter
• FOBT kit with instructions
• information booklet
• Participant Details Form.

What an FOBT involves

The difference between a 'guaiac' and an 'immunochemical' FOBT

Other ways patients can obtain an FOBT

What an FOBT involves

• The National Bowel Cancer Screening Program is using an FOBT called ‘Bayer Detect'.

• The type of FOBT used in the National Bowel Cancer Screening Program is an immunochemical test that does not require special dietary restrictions.
• FOBTs are not diagnostic (i.e. they do not detect cancer) but can identify people who require further testing.
• The FOBT can be done at home.
• Participants need to take samples from two separate bowel motions.  This increases the chance of detecting tiny amounts of blood.
• Participants should take the FOBT within two weeks and no later than two months after receiving the kit.  
• The kit must be stored in a cool place (no higher than 25°C) before and after use. In a climate where the room temperature is higher, it may be stored in the refrigerator, but well away from food, and not frozen.
• Participants should read the instructions carefully before performing the test.
• Once collected, participants place the samples with their signed Participant Details Form into the pre-paid envelope and post them to the laboratory. 
• The laboratory will send the test result to the participant and their doctor (if nominated).
• The result of an FOBT is either positive (blood detected) or negative (no significant traces of blood) or inconclusive (unable to determine a positive or negative value).
• A participant who has a positive result will need to discuss the result with their doctor. That's why everyone is encouraged to nominate a doctor on the Participant Details Form.  
• If the participant does not see a regular doctor, but attends a clinic or service, such as an Aboriginal Medical Service, they can nominate that service.

The difference between a ‘guaiac' and an ‘immunochemical' FOBT

• There are two types of FOBT: guaiac and immunochemical FOBTs. The National Bowel Cancer Screening Program is using an immunochemical test.
• When using a guaiac test, a person should not consume red meat, specific fruit and vegetables (for example, raw broccoli), vitamin C supplements, aspirin or anti-inflammatory drugs for three days prior to taking their first test sample and throughout the testing period.
• There are no restrictions on diet or medication for immunochemical FOBTs.
• Therefore the immunochemical test is seen to be less intrusive, more acceptable and more likely to achieve higher participation rates.

Other ways patients can obtain an FOBT

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.

There are two general types of FOBT: a ‘guaiac' test which requires dietary modification a few days before the test; and an ‘immunochemical' test which does not require dietary modification. There are several brands of each test type, but not all are commercially available.

Options:

1. Many GPs can provide FOBTs. The FOBT would be completed at home and sent to a laboratory for analysis, with payment.
2. The Bayer Detect FOBT, being used in the National Bowel Cancer Screening Program, is not currently commercially available but may be in the future.
3. The !nform FOBT, used during the pilot program, is available through many general practices and also on the internet: http://www.enterix.com.au/. Currently $34 or $30 if prepaid.
4. Some pharmacies sell FOBTs.
5. Rotary has been running a BowelScan Program for several years, selling guaiac FOBTs through selected pharmacies.
6. Some health insurance funds provide FOBTs to their clients.
7. Victorian residents can contact The Cancer Council Victoria's Helpline on 13 11 20, and if eligible, obtain an FOBT at a reduced cost.

Updated June 2007