Fecal occult blood testing for colorectal cancer. Can we afford to do this?

Gastroenterol Clin North Am. 1997 Mar;26(1):41-55. doi: 10.1016/s0889-8553(05)70282-x.


Fecal blood is an inherently insensitive and nonspecific marker for asymptomatic colorectal neoplasia. As such, use of fecal occult blood tests (FOBTs) necessarily limits the effectiveness and efficiency of a screening application. FOBT screening may result in a modest reduction in colorectal cancer-specific mortality, but it alters neither colorectal cancer incidence nor overall mortality. Costs resulting from FOBT screening are substantial, and the extent to which screen-induced mortality offsets any benefits remains unknown. In the absence of a clearly demonstrated net benefit with FOBT screening, affordability of this expensive effort can be legitimately questioned.

Publication types

  • Review

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / economics
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / prevention & control*
  • Humans
  • Mass Screening* / economics
  • Occult Blood*
  • Predictive Value of Tests
  • Sensitivity and Specificity