Can I rely on the government’s at-home screening kit?

YourLifeChoices’ resident doctor offers his advice.

Can I rely on at-home screening kit?

Janet has received a do-it-yourself bowel cancer screening kit in the mail and wants to know whether she can rely on it. Dr Troye Wallett offers his advice.

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Q. Janet
What is your advice on the at-home bowel cancer test? Can I rely on it?

A. The at-home bowel cancer test is, delightfully, called the Faecal Occult Blood test or FOB. You may have received it in the post as part of the Government’s free screening program. The instructions are on the pack, but basically, you poke your poo with a stick, pop it in a container and send it off in the post. You’re likely to receive a response within two weeks.

The goal of the National Bowel Cancer Screening program is to reduce the number of colon cancer deaths through early diagnosis. But there is a price to pay. 

As a result of the screening, more people will be diagnosed with cancer and pre-cancer – and go through the stress and anxiety of the diagnosis and the recommended treatment – yet the disease may never have manifested in a proportion of that group. So is that worth it? I would say ‘Yes’ and the Government obviously agrees, hence the screening program. 

Suffering is the price we pay for preventing death. That is true for all screening tests.

Risk factors for colon cancer include:

  • being overweight
  • physical inactivity
  • a diet high in processed meats
  • smoking
  • aged over 50
  • inflammatory bowel disease
  • family history of colon cancer
  • type 2 diabetes.

The higher your risk of a disease, the more you will potentially gain from a test.

My father died from colon cancer when he was 39 so I am at risk. In my case, the FOB is irrelevant because a negative test is not reassuring enough. I have a colonoscopy every five years. If I was over 50 and mildly overweight due to a dislike of exercise, the FOB would be perfect for me.

If your FOB comes back positive, i.e., blood is found in your faeces, a colonoscopy is on the agenda. If you are unsure of your risk or are concerned in any way, chat to your GP.

Troye is happy to answer your questions. Simply send an email to: newsletters@yourlifechoices.com.au

Dr Troye Wallett is a GP. He is a co-founder and part-owner of GenWise, an ethics-based, purpose-driven mobile general practice which supports health professionals working in aged care.

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    COMMENTS

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    Alky
    2nd Jul 2018
    12:22pm
    The FOB test is not accurate. I took the test when I was 50. It came back positive for blood in the faeces. I got put to the top of the list for a colonoscopy. The colonoscopy was negative and clear of polyps. The doctor who did it said that it's common for the FOB to produce false positive results.
    Last year I did the test again which came back negative. I wonder how common it is for false negatives too.
    KSS
    2nd Jul 2018
    1:33pm
    The test is for blood NOT the cancer itself. It is possible to have blood in your stools for a number of benign reasons including straining to 'go'. A positive result means little without further more invasive testing.

    This test is a screening test not a diagnostic test and that is a very important distinction.
    Anonymous
    2nd Jul 2018
    3:24pm
    KSS - you are right about "straining to go" but that blood is bright red and the one they are interested in is the dark older one from further up the chain. No alarm for a red stain after a hard stool I found.
    *Loloften*
    31st Aug 2018
    7:57pm
    Agree Alky...have received a couple over the yrs however, as a Mum who gave birth to 2 adorable sons, have haemorriods which occasionally leak blood if constipated (yuk!?). Problems easily distinguished re if have black stools not good, but not so if have normal brown ones with bit of blood on side of paper wipe....always look!! Don't trust our PO employees to NOT toss any sent items around after recent ACA show-all - our test could be a jumble/inaccurate by the time it's received. Annual Colonoscopy is the best if have family history of colorectal cancer.
    KB
    2nd Jul 2018
    12:31pm
    i do not trust any form of at home screening tests. Better to attend for any health concerns,
    Believer
    2nd Jul 2018
    3:03pm
    I got my results back after a fortnight but my husband has heard nothing in 2 months!
    Maggie
    2nd Jul 2018
    5:16pm
    My FOB tests came back negative two years in a row. My bowel cancer was detected only after I landed in A&E because I could no longer put one foot in front of the other.

    I was given three pints of blood immediately and sent for a colonoscopy. The gastroenterologist said that he had taken a specimen but he could tell me right away that I had cancer.

    When I told him I had had negative FOB results he told me they are only 40% accurate. My cancer had already advanced to Stage 2.

    Ask for a colonoscopy if anyone in your family has had bowel cancer or if you feel unsure about what is happening to you at any time.

    2nd Jul 2018
    6:06pm
    My FOB test was negative but I still have my 5 yearly test due to fact my father had colon cancer.
    Eddy
    2nd Jul 2018
    10:09pm
    One of my siblings suffered bowel cancer so I was recommended to have a colonoscopy. Polyps were found so the recommended interval for my colonoscopy is 3 years. The actual colonoscopy is the easy part (I sleep through it), the preparation is daunting.
    Trevndawn
    4th Jul 2018
    1:44pm
    I think that the point Janet is making is that the kit is questionable!
    I received my kit in the summer, with instructions to refrigerate the first sample.
    What happens when the samples spend X amount of time in transit from my fridge to the test lab? In summer I would suggest that they are nearly cooked in a mail van.
    Hence I believe that the test is of little use other than giving a few technicians a job.
    ggrob
    4th Jul 2018
    10:46pm
    Returned from an overseas trip and had a knee operation after which it was suggested I have a colonoscopy due to lack of iron. This I ignored but agreed to an iron transfusion. Two more iron transfusions in the following six months and my GP finally persuaded me to have colonoscopy, but only after mt FOB result came through as positive. Result was early stage bowel cancer and me having operation and consequent chemo. With hip (5) and the knee replacements didn’t think I needed that extra health issue. Now everyone (family and many many friends) happy as the ‘old lady’ isn’t going to go too soon, so they tell me.
    musicveg
    7th Jul 2018
    7:44pm
    I think the home testing kits are a waste of money and resources, I just threw mine in the bin because I did not feel I needed to be checked, and I already had a check by the doctors. They should stop sending them out and put the money elsewhere in the health care system.


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