Immunochemical detection of fecal occult blood –. The fecal smear punch-disc test: A new non-invasive screening test for colorectal cancer

Authors:
  • CSCurtis L. Songster
    Curtis L. Songster
  • GBGeorge H. Barrows
    George H. Barrows
  • DJDiane D. Jarrett
    Diane D. Jarrett
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Abstract
An immunochemical test for fecal occult blood was developed for use in colon cancer screening. The test employs high titer monospecific antisera to intact human hemoglobin in a radial immunodiffusion assay. Patient smears on specially treated filter paper allow screening procedures similar to those using Hemoccult slides. Minimum detectible hemoglobin was 0.3 mg/gm stool, and no cross reactivity with dietary constituents, drugs, or chemicals occurred. The accession of 150 consecutive cases of colon-rectal carcinoma was accomplished from three community hospitals. In each instance, at least one preoperative fecal specimen was obtained for companion smear testing with immunochemical punch-disc and commercial Hemoccult slides. Twenty-nine percent of the cases were found not to be bleeding by either test. Occult bleeding was detected by Hemoccult in 40% of the cases, and occult bleeding was detected by immunochemical testing in 65% of the cases. A surprising discovery was that rectal lesions had a much lower rate of of positiuity with both tests (Hemoccult-29%, Immunochemical-50%) than other locations. These results suggest that immunochemical screening for occult blood loss will provide a higher rate of detection of colon cancer.

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