Value of fecal occult blood test as a screening test before capsule endoscopy

Background The primary aim was to assess the value of immunochemical and guaiac fecal occult blood test (FOBT) as a screening test before capsule endoscopy (CE) in the setting of obscure gastrointestinal bleeding (OGIB). Methods A prospective study from the St Vincent's Hospital, a tertiary referral hospital in Melbourne, Australia. Sixty-eight patients referred for CE to investigate OGIB underwent two immunochemical/guaiac FOBTs within 2 weeks preceding CE. The correlation between a positive FOBT before CE and clinically significant findings (CSFs) on CE was assessed. Results Thirty of 68 (44%) patients with OGIB had significant findings on CE. The accuracy of a combined immunochemical and guaiac FOBT for predicting clinically significant findings on CE was 62% [95% confidence interval (CI): 0.50-0.72]. The sensitivity and specificity were low at 63% (95% CI: 0.50-0.75) and 61% (95% CI: 0.50-0.70), respectively. Conclusion FOBT has low accuracy as a screening test before CE and thus cannot be recommended for this purpose. Eur J Gastroenterol Hepatol 23: 690-694 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.