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A fecal occult blood test (FOBT) looks for small amounts of hidden blood in your stool. These traces of blood aren’t visible to you, but they could signal a problem in your digestive tract. For the test, you’ll take stool samples at home and send them to a lab for testing.
Several digestive conditions cause trace amounts of blood in your stool, including colon polyps or colorectal cancer. FOBT is one option to screen for colon and rectal cancer, but follow-up tests are needed to diagnose the cause if you get a positive result.
If you need a fecal occult blood test, there are a few different types of tests your doctor might order. Some tests look for trace amounts of blood in the stool, while others look for blood and DNA markers to help detect possible digestive conditions.
No matter the type of test you choose, stool samples are usually collected in the comfort of your own home. If you have a fecal occult blood test as a screening for colon cancer, how often you need the test will depend on the type you choose.
Sometimes called an iFOBT, this test looks for hidden blood in your stool and should be performed every year if you’re using it to screen for colorectal cancer. It is more sensitive and doesn’t require diet changes, so it’s usually preferred over gFOBT. Following your kit's instructions, you’ll collect a stool sample at home and mail it to the lab.
Like a FIT test, gFOBT detects trace amounts of blood in the stool and should be done every year for screening. But this type of test can be affected by non-steroidal anti-inflammatory drugs, vitamin C, or eating red meat or raw produce, so you’ll have some restrictions in the days before your test. You’ll also need to take multiple stool samples for gFOBT. Due to these issues, this test is less commonly used.
This test combines looking for hidden blood along with DNA markers in your stool that might be released by precancerous polyps or colorectal cancer. As a screening test, stool DNA tests are recommended every three years. This type of stool test requires a full stool sample that’s collected at home.
FOBT is most commonly performed as a screening test for colon cancer and rectal cancer. If you don’t have any risk factors for colorectal cancer, including a family history of colon cancer or symptoms, this test may be an option for you starting at age 45. FOBT can also be used when you have signs of a digestive condition.
Your doctor might order a FOBT if you have digestive symptoms or anemia—a condition in which you have a low red blood cell count. This test can help uncover hidden bleeding in the digestive tract so that your doctor can recommend your next steps.
For colorectal cancer screening, the timing of a fecal occult blood test depends on the test you choose—every year or every three years. Guidelines recommend routine colorectal cancer screening for people with an average risk starting at age 45.
If you choose FIT or gFOBT, you’ll need to have the test every year. If you choose a stool DNA test, you should have the test every three years as long as your test is negative. If your test comes back positive, you will have to get a colonoscopy.
You can get fecal occult blood tests over the counter or through your doctor. But before taking a FOBT, talk with your doctor about if this type of test is right for you. Your doctor can also guide you on any restrictions before the test to help give you the most accurate results.
Each type of test has its own steps, so be sure to follow your kit’s instructions. In general, a FOBT doesn’t require a lot of prep ahead of time and can be done from your home.
If you choose a FIT or stool DNA test, you won’t need to modify your diet before your test. However, if you chose a gFOBT, your doctor may have you:
If you have certain conditions that cause bleeding, like hemorrhoids or ulcers, if you have blood in your urine or if you’re on your period, blood could be detected on your screening test when it’s not really a sign of cancer or polyps. You should not take the test in these cases.
During your test, you’ll have a kit and instructions to guide you through each step. There are a few different ways to collect samples, and tests vary in the number of samples needed. But the general steps for most tests include:
If you had any diet or medication restrictions before your test, you can resume your normal routine right after the test. You can expect to get the results from your test in about a week, but ask your doctor or lab for a specific timeline.
Fecal occult blood tests can only detect the presence of blood in the stool—and, depending on the test, DNA markers. While they are helpful tools for your health and peace of mind, it’s important to understand that these tests can’t diagnose or confirm a condition. Be sure to talk to your doctor about what your results mean for you and your next steps.
