Answer: The traditional test involves putting a small sample of stool on a guaiac card and then adding a few drops of developer that will turn blue in the presence of blood. It's been used for years, even though it does not have great sensitivity (it fails to correctly identify the presence of blood about half the time) or specificity (blood from red meat can falsely indicate the presence of blood in the stool).

The new fecal immunochemical (FIT) testing for occult (nonvisible) blood in the stool involves the use of a special immunochemical that has a sensitivity of greater than 87 percent, detecting the most minute amounts of hemoglobin in blood. It has a specificity of more than 96 percent because the assay is highly specific for human hemoglobin. Vitamin C and certain medications can affect the accuracy of a traditional occult blood test, but not the newer FIT.

Since bleeding may occur intermittently and be missed in random testing, even with this much more sensitive FIT test, routine colon screening with colonoscopy must be done in conjunction at regular intervals.

Not here yet, but no-scar surgery is promising

A: The surgery you're describing is not yet "ready for prime time," although it definitely shows promise as an alternative to a number of laparoscopic and traditional abdominal surgeries. It's called NOTES, an acronym for Natural Orifice Transluminal Endoscopic Surgery. NOTES eliminates the need for traditional incisions and, for the right type of patient, results in less painful surgery with a more rapid recovery time. Two examples of NOTES surgery are a transvaginal appendectomy and a transvaginal cholecystectomy (gallbladder removal), where a small incision is made through the vaginal wall to gain access to the abdominal cavity and its organs. Each requires only two small incisions, one in the abdomen and one in the vagina.

Another surgical area where NOTES surgery holds tremendous promise is bariatric weight loss surgery. Imagine weight loss surgery without any incisions.

Incisionless transoral gastroplasty, for people in need of moderate weight loss, involves placing a vacuum device down the throat and into the stomach to bring the sides of the stomach together to be stapled without incisions. Another example of NOTES weight reduction surgery is transvaginal sleeve gastrectomy, where the vagina is used as a portal of entry to remove 70 percent of the stomach.

If shown to be safe and effective by the FDA, these NOTES procedures offer same-day surgery options with return to work and home activities within just a few days.