Fecal Occult Blood Testing in Acute Care Settings: A Review of Clinical Utility [Internet]

Excerpt

Gastrointestinal bleeding (GIB) can be a substantial clinical and economic burden to the patient and the healthcare system. GIB can be classified as obscure, occult, or overt. Overt GIB presents with visible bleeding with bloody vomit or stool; occult GIB is not visible to the physician or the patient; and obscure GIB refers to recurrent bleeding after a negative initial evaluation using tests such as upper endoscopy, small bowel radiography, or colonoscopy. Occult bleeding is often associated with a colorectal source. Fecal occult blood test (FOBT) is a lab test used to check stool samples for occult blood and is often used to screen for colorectal cancer. FOBT is indicated for use in the general population for colorectal cancer screening programs. However, it is often not validated for use in the hospital setting. Two hospitals in Canada and the United States have moved to disinvest in the use of FOBT in the non-screening acute care population in 2017 and 2018 respectively.^, This review seeks to determine the updated clinical utility evidence since the 2017 CADTH Rapid Response Report regarding fecal occult blood tests for the identification of gastrointestinal bleeding in acute care settings outside of screening for colorectal cancer.