Objective: Colorectal cancer is a major health problem causing high mortality and short survival after diagnosis. Both the cancer itself and its precancerous lesion, the adenomatous polyp, can provoke occult bleeding. Screening programs for cancer of the colon use the Hemocult II test to detect such occult bleeding. We report the results obtained after 16 years of screening with the Hemocult II at the Paris tumor prevention center.
Methods: Since 1980, an annual Hemocult II test has been proposed to all consulting patients over the age of 40 years. Tests were self-administrated and returned to the center by mail. After rehydration, the tests were read by center nurses.
Results: The test was well accepted by the patients (78-90%). Over 16 years, the test led to the diagnosis of 18 cases of cancer, two-third of which were in an early stage (Dukes A) as well as 84 adenomatous polyps including 25% with signs of moderate to severe dysplasia and one case of diffuse adenomatous polyposis. Test sensitivity was 60%, with a 97% specificity and an overall (cancer and precancerous lesions) positive predictive value of 28.3%. In light of published data on the adenoma-cancer relationship, it can be estimated that 6 cancers were avoided.
Conclusion: Hemoccult II is an easy to perform low-cost test well accepted by patients. Its use in a screening program can detect early stage precancerous and cancerous lesions of the colon.
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