Patients with a negative fecal occult blood testing (FOBt) result whom were later diagnosed with colorectal cancer report a lower trust in the FOBt but do not report worse psychological outcomes, according to an article published online in Cancer Epidemiology, Biomarkers & Prevention.
After fifteen patients withheld consent to data matching with medical records, there was a sample of 296 patients. There were three categories outlined regarding the patients’ diagnosis: (i) interval cancer (after receiving a negative FOBt result), (ii) a positive, screen-detected cancer result, or (iii) in regions where there was no screening offered.
Patients in all three cohorts completed questionnaires regarding quality of life (FACT-C), depression (CES-D), perceived diagnostic delay, and trust in the FOBt results.
Results showed that patients with an interval cancer reported a lower quality of life and a greater diagnostic delay (difference in means = 6.16, P=0.03 and OR = 0.37; P=0.02, respectively). The interval cancer cohort expressed the highest distrust in FOBt. There was no significant difference reported in depression or between the interval cancer group and the group not offered screening.
The study suggests that improvements be made to the test’s sensitivity in order to stimulate increased quality of life in patients.
Patients with a negative fecal occult blood testing result later diagnosed with colorectal cancer report a lower trust in the test.
Screening using fecal occult blood testing (FOBt) reduces colorectal cancer mortality, but the test has low sensitivity. A “missed” cancer may cause psychologic harms in the screened population that partially counteract the benefits of early detection.