The Findings and Impact of Nonrehydrated Guaiac Examination of the Rectum (FINGER) Study

Abstract

SCREENING FOR fecal occult blood has been shown to reduce mortality from colorectal cancer,^1-3 the second leading cause of cancer death in the United States.⁴ Because 70% to 80% of colorectal cancers are diagnosed in "average-risk" patients,⁵ the American Cancer Society recommends annual fecal occult blood testing (FOBT) of stool samples in all patients aged 50 years or older using 3 specimens obtained from spontaneously passed stools (SPS).⁶ To decrease the number of false-positive FOBT results, patients are placed on dietary restrictions, and nonsteroidal anti-inflammatory drug (NSAID) and aspirin use is discontinued 1 week before testing. Despite these recommendations, clinicians often test stool samples for occult blood at the time of digital rectal examination (DRE).⁷ Although widely practiced, this screening method has been discouraged because it is thought to increase the number of false-positive FOBT results.^8,9