Annals of Oncology 13:44-46, 2002
© 2002 European Society for Medical Oncology
Debate |
Hemoccult should no longer be used for the screening of colorectal cancer
Institut Jules Bordet, Brus sels, Belgium
Received 9 August 2001; accepted 11 October 2001.
Key words: colorectal cancer, faecal occult blood, screening
About 50% of the patients with colorectal cancer who are diagnosed on the basis of clinical symptoms could be cured by surgery. It may be assumed that diagnosis and surgery at an earlier asymptomatic stage would allow more patients to be cured. Therefore, screening appears to be the simplest way to decrease mortality due to colorectal cancer [1].
The most widely investigated screening procedures are faecal occult blood testing (FOBT) and sigmoidoscopy or total colonoscopy.
FOBT would allow detection of cancer in the entire colon. Guaiac gum remains the most widely used indicator for occult bleeding and of the many commercial tests using guaiac gum, the most popular and the most extensively studied is Hemoccult.
The chemical test for occult blood depends upon an oxidation process that is catalysed by a number of naturally occurring peroxydases and catalases. Therefore, many non-heme compounds can be responsible for the high
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