Routine hemoccult screening: the current evidence.

Screening for colorectal carcinoma with the Hemoccult® test has been widely recommended for routine use in those over age 45. This review critically evaluates current evidence for the maneuver's efficacy, effectiveness, and efficiency. To date, no controlled trials have demonstrated clear-cut improvements in cancer survival or quality-of-life after Hemoccult screening. However, significant risks and costs attend the test's administration because of the invasive confirmatory investigations now recommended for each positive screening result. In view of the uncertain benefits, substantial risks and high costs of occult-blood screening, further evidence should be available of its ability to produce cancer mortality reductions before this intervention is included in the periodic health examination at any age.