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• W2018977213 abstract "Many patients with a positive fecal occult blood test (FOBT) do not undergo follow-up evaluations. To identify the rate of follow-up colonoscopy following a positive FOBT and determine underlying reasons for lack of follow-up. It is a retrospective chart review. The subject group consisted of 1,041 adults with positive FOBTs within a large physician group practice from 2004 to 2006. We collected data on reasons for ordering FOBT, presence of prior colonoscopy, completed evaluations, and results of follow-up tests. We fit a multivariable logistic regression model to identify predictors of undergoing follow-up colonoscopy. Most positive FOBTs were ordered for routine colorectal cancer screening (76%), or evaluation of anemia (13%) or rectal bleeding (7%). Colonoscopy was completed in 62% of cases, with one-third of these procedures identifying a colorectal adenoma (29%) or cancer (4%). Factors associated with higher rates of follow-up colonoscopy included obtaining the FOBT for routine colorectal screening (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.11–2.29) and consultation with gastroenterology (OR 1.99, 95% CI 1.46–2.72). Patients were less likely to undergo colonoscopy if they were older than 80 years old (OR 0.54, 95% CI 0.31–0.92), younger than 50 years old (OR 0.44, 95% CI 0.28–0.70), uninsured (OR 0.50, 95% CI 0.27–0.93), or had undergone colonoscopy within the prior five years (OR 0.32, 95% CI 0.23–0.44). Clinical decisions and patient factors available at the time of ordering an FOBT impact performance of colonoscopy. Targeting physicians’ understanding of the use of this test may improve follow-up and reduce inappropriate use of this test." @default.
• W2018977213 created "2016-06-24" @default.
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• W2018977213 date "2009-01-08" @default.
• W2018977213 modified "2023-10-07" @default.
• W2018977213 title "Challenges in the Management of Positive Fecal Occult Blood Tests" @default.
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• W2018977213 doi "https://doi.org/10.1007/s11606-008-0893-5" @default.
• W2018977213 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/2642561" @default.
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