Talk:Fecal occult blood

message: This source discusses the decision whether in ICD10, faecal occult blood should be coded to "R19.5 – Other faecal abnormalities" or "K92.1 -  Melaena", and concludes that because "ICD10 can’t measure the quantity of blood, a diagnosis of faecal occult blood should be coded to K92.1 -  Melaena". --Arcadian 14:19, 23 December 2005 (UTC)
thread_title: ICD10 code in infobox

message: I tried to trim some of the excessive marketing hype.  The article has been infected by too many confusing trademark terms.  It needs to get cleaned up and organized, by someone who actually understands the trademarks.-69.87.203.221 00:56, 28 June 2007 (UTC)
thread_title:  Trademarks 

message: According to the National Guideline Clearinghouse™ (NGC), a public resource for evidence-based clinical practice guidelines. 
at
http://www.guideline.gov/summary/summary.aspx?doc_id=14345 
[All emphasis added.]
Colorectal cancer screening clinical practice guideline  
MAJOR RECOMMENDATIONS
Definitions of the levels of evidence (evidence-based A-D, I and consensus-based) are provided at the end of the "Major Recommendations" field.
Recommendation 1*: Factors Associated with an Increased Risk of Colorectal Cancer in the General Population
... 
Recommendation 2: Effectiveness of Colorectal Cancer Screening Tests
1. Colorectal cancer screening is strongly recommended for all asymptomatic, average-risk adults. (Evidence-based: A)
2. Any of the following tests are acceptable for colorectal cancer screening in asymptomatic, average-risk adults:*
* High-sensitivity' fecal occult blood test (FOBT) (Consensus-based)
* Immunochemical fecal occult blood test (iFOBT/FIT)** (Consensus-based)
* Flexible sigmoidoscopy (Evidence-based: B)
* Colonoscopy** (Consensus-based)
* A combination of high-sensitivity guaiac FOBT test and flexible sigmoidoscopy (Consensus-based)
3. The following additional screening tests are either less-preferred options or not recommended for screening.  However, an adult who has had one of these tests is considered screened. Follow-up screening using a preferred option is recommended.
* An annual standard guaiac FOBT is a less-preferred option.*** (Consensus-based)
* Air contrast barium enema is not recommended as a screening strategy for average-risk adults. (Evidence-based: I)
* Virtual colonoscopy is not recommended as a screening strategy for average-risk adults.* (Consensus-based)
* Fecal DNA is not recommended as a screening strategy for average-risk adults.****(Consensus-based)
Note: For fecal blood tests, inform patients of the potential risks associated with false-positive test and false-negative test results, as well as the need for prompt follow-up of a positive test result.  For flexible sigmoidoscopy, inform patients that the test has a small risk of complications and is not a complete examination of the entire colon.
*There is insufficient evidence to choose one screening test over another.
**If a patient has had a normal colonoscopy within the last 10 years, there is insufficient evidence that supplemental FOBT adds any incremental benefit.
***Even though there is sufficient evidence in support of this screening modality, it is not a preferred option due to its low sensitivity and low compliance rates.
****Please note that fecal DNA testing and virtual colonoscopy are not listed as "appropriate screening tests" in 2008 HEDIS (Health Plan Employer Data and Information Set) specifications for colorectal cancer screening, and therefore regions may choose to screen members with other appropriate tests.
Recommendation 3: Frequency of Colorectal Cancer Screening
1. The following intervals for colorectal cancer screening in asymptomatic, average-risk adults are recommended*:
* Flexible sigmoidoscopy: at least every 10 years (Consensus-based)
* High-sensitivity guaiac or immunochemical FOBT (iFOBT/FIT): every 1-2 years (Consensus-based)
* Colonoscopy: every 10 years (Consensus-based)
* Combined FOBT and flexible sigmoidoscopy: every 1-2 years for FOBT, at least every 10 years for flexible sigmoidoscopy (Consensus-based)
2. The following additional screening tests are either less-preferred options or not recommended for screening. However, if these tests are performed, then the recommended intervals are as indicated below. Follow-up screening using a preferred option is recommended.
* Standard guaiac FOBT: every 1-2 years (Consensus-based)
* Air contrast barium enema:** every 5 years (Consensus-based)
* Virtual colonoscopy:** every 10 years (Consensus-based)
* Fecal DNA:** every 5 years (Consensus-based)
* The GDT recognizes that these screening intervals differ from current HEDIS measures.  Some regions may choose to offer screening at more frequent intervals.  HEDIS intervals are as follows: FOBT (annual), flexible sigmoidoscopy (every 5 years), air contrast barium enema (every 5 years), colonoscopy (every 10 years).
**These modalities are not recommended for screening average-risk adults (see Recommendation #2 above).
Recommendation 4: Age to Begin and End Colorectal Cancer Screening
In the absence of sufficient evidence, the following ages at which to begin and end colorectal cancer screening in asymptomatic average-risk adults are recommended:
1. Initiation of screening is recommended at age 50. (Consensus-based)
2. Discontinuation of screening is generally recommended at age 75, provided that there is a history of routine screening. For those with no history of routine screening, discontinuation is recommended at age 80. The decision to discontinue screening should be based on physician judgment, patient preference, the increased risk of complications in older adults, and existing comorbidities. (Consensus-based)</small>   —Preceding unsigned comment added by Ocdcntx (talk • contribs) 15:22, 15 February 2010 (UTC)
thread_title:  Evidence based screening 

message: See illustration:  
"Cards and bottle used for the Hemoccult test, a type of stool guaiac test.  —Preceding unsigned comment added by Ocdcntx (talk • contribs) 15:59, 15 February 2010 (UTC)
thread_title:  Suggest replace photo of brand name guaiac FOBT, which is no longer preferred, with photo of a high-senstivity test, which is 

message: Note that if a "guaic" FOBT is not recommended unless both (A) high-sensitivity and (B) even then, only when combined with a regular flex sig. 
http://www.guideline.gov/summary/summary.aspx?doc_id=14345
... 
MAJOR RECOMMENDATIONS
Definitions of the levels of evidence (evidence-based A-D, I and consensus-based) are provided at the end of the "Major Recommendations" field.
Recommendation 1*: Factors Associated with an Increased Risk of Colorectal Cancer in the General Population
...
Recommendation 2: 
1. Colorectal cancer screening is strongly recommended for all asymptomatic, average-risk adults. (Evidence-based: A) 
2. Any of the following tests are acceptable for colorectal cancer screening in asymptomatic, average-risk adults:*
* High-sensitivity' fecal occult blood test (FOBT) (Consensus-based)
* Immunochemical fecal occult blood test (iFOBT/FIT)** (Consensus-based)
* Flexible sigmoidoscopy (Evidence-based: B)
* Colonoscopy** (Consensus-based)
* A combination of high-sensitivity guaiac FOBT test and flexible sigmoidoscopy (Consensus-based)
Ocdcntx (talk) 19:23, 15 February 2010 (UTC)
thread_title:  Major recommendations of best practices excluding most guaiac FOBT need to be laid into article.    

message: Graphic is traditional gFOBT, which is no longer recommended.  Replace with graphic of currently-recommended test.  — Preceding unsigned comment added by Ocdncntx (talk • contribs) 18:19, 20 September 2011 (UTC)
thread_title:  Graphic needs replacement 

message: It would be very useful to add a new section to the article about the signs and symptoms that warrant tests for fecal occult blood. (I was actually looking for that information when I checked this article.) 84.0.42.178 (talk) 09:51, 24 January 2013 (UTC)
thread_title:  Signs and symptoms of possible GI bleeding? 

message: This article refers several times to "guidelines", "best practices recommendation" and the like, with no reference to what places use these guidelines. For example, the guaiac test is still the test sent out for routine screening in the UK. If the guidelines mentioned are the ones used in America, fair enough, but say so!
The Fecal DNA Test has little relevance to this page, as (according to its name, and the description here) it does not test for faecal occult blood. This page is about faecal occult blood testing, not colorectal cancer testing, which I'm sure is covered elsewhere.
Browneyedgirl13 (talk) 10:14, 13 September 2013 (UTC)
thread_title:  Wrong focus in article 

message: Where is the FIT-iFOBT article to correspond to the gFOBT article?-71.174.175.150 (talk) 19:44, 14 November 2014 (UTC)
thread_title:  FIT-iFOBT 

message: This is a tricky article to get right! It is ostensibly about Fecal Occult Blood tests, and yet in general the purpose of such tests, and the goals of most readers, has to do with colon cancer. On the one hand, the proper measure of an FOB test should be whether it reliably detects fecal blood, at various levels. And that should be the proper context for judging False Neg and False Pos rates, narrowly defined. But I think in the real world these tests are judged by colonoscopies and colon cancer correlations. Somehow the article should separate out these two different perspectives on the test accuracies?-71.174.175.150 (talk) 22:03, 14 November 2014 (UTC)
thread_title:  false neg / false pos 

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thread_title:  External links modified