Sensitivity of Hemoccult test for large bowel cancer in high-risk subjects

L. Bertario, P. Spinelli, L. Gennari, P. Sala, P. Pizzetti, A. Severini, G. Cozzi, M. Bellomi, F. Berrino

Research output: Contribution to journalArticlepeer-review


From 1979 to 1982, 1233 symptom-free subjects at high risk for colon cancer because of family history and/or personal history of bowel neoplasia (cancer or adenomatous polyp) were examined with a guaiac test (Hemoccult II) for occult blood in stools. The test was positive (H+) in 98 subjects (7.9%). Endoscopy was subsequently performed on 86% of the H+ and on 64% of the H-subjects. Of 20 in invasive cancers found, 15 had been H+ [75.0%; 95% confidence interval (CI), 54.3-91.0%]. Of 96 patients with adenoma(s), 23 were H+ (24%; 95% CI, 16.0-33.0%). However, the sensitivity for adenomas was higher in patients with multiple adenomas or with a single adenoma measuring 2 cm or more in its largest diameter (37.5%; 95% CI, 21.8-54.7%). Of 699 subjects free of neoplastic lesions at endoscopy, 47 had been H+, ie, false positive (6.7%; 95% CI, 5.0-8.7%). Adjusting for differential compliance of H+ and H-subjects to endoscopy, a corrected estimate for sensitivity would be 69% for cancer and 19% for adenomas; the corrected estimate for the false-positive rate would be 5%.

Original languageEnglish
Pages (from-to)609-613
Number of pages5
JournalDigestive Diseases and Sciences
Issue number5
Publication statusPublished - May 1988


  • colorectal cancer
  • hemoccult
  • screening

ASJC Scopus subject areas

  • Gastroenterology


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