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BACKGROUND : We wanted to examine the extent and value of testing in a general practice for occult blood in faeces in patients suspected of having colorectal cancer. MATERIAL : All patients treated for colorectal cancer in the surgical department in the district hospital 1985-98 were registered (n = 880) and names compared to the files in a general practice in Arendal. The files of our patients were examined in order to determine patients' and doctor's delay in diagnosing the disease and whether testing of occult blood in faeces was used in the examination. In addition, all patients in the practice tested with occult blood in faeces (Hemofec) 1985-94 were noted (n = 962) and the files of 20 % of them examined. RESULTS : The five general practitioners in our practice were responsible for diagnosing 74 of the patients with verified colorectal cancer (approx. one new patient per doctor per year). Patients' mean delay was 1.7 months (median 1.1), doctor's delay mean 1.8 months (median 0.9). In 25 patients the examination of occult blood in faeces was part of the diagnostic workup. 20 of the patients tested positively, five negatively. In 71%, the reason for testing was non-specific abdominal symptoms. Among these patients, 11% tested positively and 89% negatively. INTERPRETATION : Examination of occult blood in faeces has a limited role to play in the diagnosing of colorectal cancer, though a negative result is valuable in order to exclude colorectal cancer in patients with non-specific abdominal complaints and thus prevent unnecessary use of colonoscopy.

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