Faecal Occult Blood (FOB)

General Information

PLEASE NOTE: From 01/08/2012, faecal occult blood (FOB) analysis is no longer available in laboratories at Heart of England NHS Foundation Trust.

FOB analysis has 73% sensitivity and 60% specificity for occult blood loss.  Guidelines do not recommend FOB analysis for general screening (see references  below).  The National Bowel Cancer Screening Programme screens all male and females in England between the ages of 60 and 69 years.  Screening is intended for asymptomatic individuals.  For more information please refer to the NBCSP website (http://www.cancerscreening.nhs.uk/bowel/index.html).  It is recommended that symptomatic individuals should be referred.  

British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia states: FOB testing is of no benefit in the investigation of Iron Deficiency Anaemia.

Scottish Intercollegiate Guideline Network 67 states: Although faecal occult blood testing (FOBT) is an effective means of population screening, it is too sensitive to be used in guiding investigation of symptomatic patients.

NICE Guidelines for Referral for suspected Cancer (CG271, sections on upper and low gastrointestinal cancer) states: In patients for whom the decision to refer has been made, no examinations or investigations other than those referred to earlier (abdominal and rectal examination, full blood count) are recommended as this may delay referral.