Immunochemical detection of fecal occult blood--the fecal smear punch-disc test: a new non-invasive screening test for colorectal cancer

Cancer. 1980 Mar 15;45(5 Suppl):1099-102. doi: 10.1002/1097-0142(19800315)45:5+<1099::aid-cncr2820451312>;2-t.


An immunochemical test for fecal occult blood was developed for use in colon cancer screening. The test employs high titer monospecific antisera to intact human hemoglobin in a radial immunodiffusion assay. Patient smears on specially treated filter paper allow screening procedures similar to those using Hemoccult slides. Minimum detectible hemoglobin was 0.3 mg/gm stool, and no cross reactivity with dietary constituents, drugs, or chemicals occurred. The accession of 150 consecutive cases of colon-rectal carcinoma was accomplished from three community hospitals. In each instance, at least one preoperative fecal specimen was obtained for companion smear testing with immunochemical punch-disc and commercial Hemoccult slides. Twenty-nine percent of the cases were found not to be bleeding by either test. Occult bleeding was detected by Hemoccult in 40% of the cases, and occult bleeding was detected by immunochemical testing in 65% of the cases. A surprising discovery was that rectal lesions had a much lower rate of of positiuity with both tests (Hemoccult-29%, Immunochemical-50%) than other locations. These results suggest that immunochemical screening for occult blood loss will provide a higher rate of detection of colon cancer.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / prevention & control*
  • Diagnostic Errors
  • Feces / analysis*
  • Gastrointestinal Hemorrhage / diagnosis
  • Humans
  • Immunochemistry
  • Mass Screening / methods*
  • Occult Blood*
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / prevention & control*