Faecal occult blood: what it is, what it tells you and when it’s tested

The faecal occult blood test looks for traces of blood in your stool that you cannot see. Bowel polyps and cancers can bleed a little, for a long time, before they cause symptoms. In Italy this test is the free screening for bowel cancer.

When it’s tested

Mostly in bowel cancer screening. The Italian national health service invites everyone aged 50 to 69, by letter from the local health authority (ASL), to take the test every two years, free. Some regions offer it up to 74.

A doctor can also order it outside screening. But if you already have symptoms, such as blood in your stool, bowel habits that have changed for weeks or anaemia, you usually need a check and often a colonoscopy, not just this test.

Rosa does not run it: it is not a blood test, and there is already a free public programme that works. Rosa measures haemoglobin, ferritin and MCV, which can show iron deficiency anaemia, sometimes caused by slow bleeding. A normal blood count does not replace screening, though.

What it tells you, and what it does not

If it is positive, there is a little blood in your stool. It does not mean cancer: it often comes from polyps, haemorrhoids or other causes. A colonoscopy is needed to find where it comes from.

If it is negative, that is good news. But it does not rule everything out: a polyp may not bleed on the day of the test. That is why the test is repeated every two years.

Done regularly, it reduces deaths from bowel cancer, because it finds polyps and cancers when they are easier to treat.

That is why it is read together with other tests:

How to read the result

In screening the result is negative or positive. The lab uses a cut-off: below it the test is negative, above it positive.

Some reports also print a number, usually in ng/mL, next to the lab’s own limit. The limit on your report is what counts.

The test used in screening is immunochemical: it only picks up human blood. That is why you do not need a special diet beforehand.

If your test is positive or negative

Bowel cancer screening in Italy

It is free at every step. It usually works like this:

If you have not had a letter, ask your ASL, a pharmacy or your doctor. If a parent, brother or sister has had bowel cancer, talk to your doctor: you may need a colonoscopy instead of this test, sometimes before the age of 50.

What to do if the test is positive

A positive test is common and usually not cancer. What matters is taking the next step:

What can skew the result

A few things can put blood in your stool without any polyps. It helps to know them beforehand.

When to worry

Talk to your doctor if:

Frequently asked questions

Positive faecal occult blood: what does it mean? That there is a little blood in your stool. It often comes from polyps, haemorrhoids or other causes, not from cancer. A colonoscopy is needed to find where it comes from.

Is screening free? At what age? Yes, it is free at every step, colonoscopy included. The ASL invites people aged 50 to 69, every two years. Some regions offer it up to 74.

How do I collect the sample? With the kit you pick up at a pharmacy or from the ASL. With the stick on the cap you take a little stool from a few spots, close the tube and hand it back soon. Follow the kit’s instructions.

Do I need a special diet before the test? No. The immunochemical test only picks up human blood, so meat and vegetables do not skew it.

I am under 50: can I take it? Outside screening you need a doctor’s prescription. If you have symptoms, such as blood in your stool or changed bowel habits, talk to your doctor: you often need a check more than the test.

Does Rosa do the faecal occult blood test? No. That is what the free ASL screening is for. Rosa measures haemoglobin, ferritin and MCV, which can show iron deficiency anaemia.

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