Preference and compliance of stool occult blood testing in a rural cancer-screening program

1030 Background: Colon cancer is the third most common cancer in men and women. Screening for colon cancer reduces the incidence of colon cancer; decreases mortality associated with colon cancer and should be an integral part of all comprehensive cancer screening programs. The impact of patient preference and compliance when given the option between guaiac-based fecal occult smear method and immunochemical assay testing was reviewed at a rural cancer-screening clinic. Methods: All cancer screening participants over age 50 were educated about colon cancer prevention and screening. The immunochemical assay test and the guaiac-based fecal occult blood test directions and costs were thoroughly explained. A sample test packet of the chosen method was shown to the participant for further explanation on the directions. Data was collected for over one year with documentation of type of preference of test taken and the return rates of those tests. Results: A total of 2170 immunochemical assay or guaiac-based fecal occult blood tests were offered to participants over age 50. The total percentage of tests taken was 39% (852 participants). 81% (688 participants) of the participants chose the immunochemical test over the guaiac-based fecal occult blood test 18% (155 participants). The return rate continued in favor of the immunochemical test with 86% (380 participants) return rate as compared with only 14% return rate for guaiac-based fecal occult blood test (60 participants). The total return rate for both test combined was 51%. Conclusion: This study revealed a surprising lack of acceptance of colon caner screening by means of stool occult blood testing despite vast efforts at thorough explanations and education. When occult blood testing was accepted immunochemical assay testing was the preferred method. Further research should focus on patient barriers in accepting colon cancer testing. No significant financial relationships to disclose.