1,300 mg of Aspirin Daily Does Not Cause Positive Fecal Hemoccult Tests
Journal of Clinical Gastroenterology (Impact Factor: 3.5). 05/1983; 5(2):123-5. DOI: 10.1097/00004836-198304000-00006
Americans 50 years of age and older are advised to test their stools for occult blood to detect colorectal neoplasms. Many will be taking 1,300 mg of aspirin daily because of cerebrovascular disease or smaller amounts for cardiovascular disease. To determine if 1,300 mg of aspirin causes positive hemoccult II tests, 27 healthy volunteers ate a red meat-free, high-fiber diet. Their stools were negative for occult blood during a 3-day control period and remained negative while they took 1,300 mg aspirin daily for an additional 7 days. This indicates that 1,300 mg aspirin daily for 1 week does not cause positive hemoccult II testing. Those taking this dose of aspirin probably need not interrupt therapy to perform hemoccult II testing.
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ABSTRACT: The author reviews the literature on occult blood surveillance for colorectal carcinoma. The guaiac-based Hemoccult (SmithKline Diagnostics, Sunnyvale, Calif.) test is the most reliable and widely used. However, testing is complicated by several technical issues that can affect clinical results, and even successful screening programs will miss a high proportion of tumors. Public compliance is often poor, and a number of indirect and "hidden" costs make surveillance programs much more expensive than is usually claimed. Almost all published screening trials are uncontrolled. They generally detect about 3-20 colorectal malignancies for every 10,000 people enrolled, but only about 5%-10% of occult blood reactions are due to cancer. Though screen-detected tumors tend to be at a relatively early stage, this does not imply any benefit of surveillance because of lead time and length biases inherent in the screening process. Only controlled trials can answer the central question of whether screening decreases mortality from bowel cancer. Two such trials are underway, but mortality data are not yet available from either.
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ABSTRACT: There are several approaches to the early detection of colorectal cancer that currently are in use in various segments of the health care system. Herein, the status of cancer control research regarding symptom and risk factor assessment, sigmoidoscopy and colonoscopy, double contrast barium enema, and fecal occult blood testing is reviewed. In addition to the different technologies of early cancer detection, there are different models of disease control intervention. These include the routine clinical activities of primary care providers as well as programmatic screening of mass populations. The currently available techniques for early colorectal cancer detection appear better suited for existing patient care settings than for programs outside the direct supervision and follow-up of the health professional.
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