[Hemoccult tests of the stool at the time of preventive gynaecological examination (author's transl)].

From January 1, 1977 on, the test for occult blood in the stool becomes, by law, part of routine preventive checkups in order to detect carcinomatous and precancerous lesions of the colon. The effectiveness and practical use of the hemoccult test in the routine gynaecological annual checkup was tested. From October 1975 to June 1976 the test was done in 1,017 women at the time of the preventive gynaecological examinations. The patients received three hemoccult test sachets. They contained guayac resin on filter paper. The stool sample is placed on the filter paper and later tested with peroxide. The patients were informed about the test. The high interest of the patients in the test was exemplified by the high return rate of 80.7%. In 29 patients at least one hemoccult test was found to be positive for a rate of 3.53%. In one of the 821 patients who returned the test a carcinoma of the rectum was discovered which was too high for digital rectal examination. An optimal test is obtained when a stool sample is placed on the filter paper on three consecutive days. When a test is positive the patient is subjected to rectal digital examination, sigmoidoscopy and air contrast barium enema. If the source of bleeding cannot be detected in this manner a coloscopy is done. If the patient followed a diet prior and during the test the rate of positive tests of 3.53% was not increased compared to the group without dietary measures. A special diet prior and during the test is therefore not necessary. The above study shows that the inclusion of the hemoccult test in preventive examinations is a rational extention of preventive testing. Combined with gynaecological preventive examinations, the additional testing for precancerous and carcinomatous lesions of the colon is of additional preventive value for the health of the women.