Stool Tests for Colorectal Cancer

British Columbia Specific Information

You can lower your risk of getting colorectal cancer by getting early colon screening. For information on colorectal screening, including the fecal immunochemical test (FIT) and who should be tested under the new BC Colon Screening program, visit British Columbia Cancer Agency Colon Screening.

For additional information on colon screening, visit Ministry of Health Colorectal Screening for Cancer Prevention in Asymptomatic Patients which also includes the Colorectal Cancer: Guide for Patients. You may also be interested in the Appendix A: Factors Influencing Colorectal Cancer Risk.

Making healthy diet and lifestyle changes can also lower your risk of getting colorectal cancer. For more information call 8-1-1 to speak with a registered dietitian, Monday to Friday from 9:00 a.m. – 5:00 p.m. Pacific Time, or you can Email a HealthLinkBC Dietitian.

Test Overview

A stool test is one of many tests used to look for colorectal cancer. Colorectal cancer affects the large intestine (colon) and the rectum. Stool tests look for signs of blood or cancer in a stool sample.

Stool tests include:

Fecal immunochemical test (FIT).
Guaiac fecal occult blood test (gFOBT).

Blood in the stool may be the only symptom of colorectal cancer. But not all blood in the stool is caused by cancer. Other conditions that can cause blood in the stool include:

Hemorrhoids.
Anal fissures.
Colon polyps.
Peptic ulcers.
Ulcerative colitis.
Gastroesophageal reflux disease (GERD).
Crohn's disease.
Aspirin or non-steroidal anti-inflammatory drugs (NSAIDs).

A stool test is one of many tests that may be used to screen for colon cancer. Other tests include sigmoidoscopy, colonoscopy, and CT colonography. Which screening test you choose depends on your risk, your preference, and your doctor. Talk to your doctor about what puts you at risk and what test is best for you.

Why It Is Done

Stool tests are done to look for blood in the stool, since cancer and polyps in the colon are more likely to bleed than normal colon tissue. If blood is found, more tests, such as a colonoscopy, will be done to find the cause.

How To Prepare

With the gFOBT, you will be given instructions about foods to avoid in the days before the test. Some medicines may also need to be stopped for a brief time before the test.

Don't do the stool tests during your menstrual period or if you have active bleeding from hemorrhoids. Also, don't test a stool sample that has been in contact with toilet bowl cleaning products that turn the water blue.

How It Is Done

There are different types of home tests. The companies that make the test kits provide instructions. To get accurate results, carefully follow the instructions in your kit.

Since colorectal cancers don't bleed all the time, some stool tests are done over several days on different stool samples. This increases the chance of finding blood in your stool if it exists.

Fecal immunochemical test (FIT)

The test kit contains the things you need to collect small samples of stool. For some types of FIT, you may need to collect a stool sample on 2 or more days.

The FIT test doesn't require a special diet in the days before you take the test.

When the test is done, follow the instructions to return the test. Some tests provide the results right away. If your test shows that blood was found, call your doctor as soon as you can.

Guaiac fecal occult blood test (gFOBT)

The test kit contains the things you'll need, such as test cards or a special test pad. You may need to collect stool samples over three different bowel movements on three different days. Be sure to follow any instructions, including those about foods or medicines to avoid in the days before the test.

Risks

There are no known risks from having this test.

Results

If your test sample is sent to a lab or returned to your doctor's office, your test results will likely be read by your doctor. Some labs may send you the results. And depending on the type of test you choose, you may be able to see the results after completing the last step.

Stool tests
Normal:	A normal FIT or gFOBT test means that there was no blood in your stool at the time of the test. Normal test results are called negative.
Abnormal:	An abnormal FIT or gFOBT test means that there was some blood in your stool at the time of the test. Abnormal test results are called positive.

Normal results

If a stool test is normal, it doesn't always mean that you don't have colorectal cancer or colon polyps. That's because these tests can miss polyps and some cancers.

Talk with your doctor about how often you should do a test, depending on your age and any risk factors you may have for colorectal cancer.

Abnormal results

A benign polyp, a precancerous polyp, or cancer can cause a positive stool test. Abnormal results can happen even if you don't have cancer. But with a positive test, there is a small chance that you could have colorectal cancer.

If your test is positive, you will need to have a colonoscopy. This would be used to see if the stool test result is from colorectal cancer.

But blood in the stool is more often caused by something other than cancer. These other causes could include hemorrhoids, ulcers, or taking aspirin.

Stool test results that are positive when you don't have cancer are called false-positive test results.