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Time from Positive Screening Fecal Occult Blood Test to Colonoscopy and Risk of Neoplasia

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Abstract

There is no guideline defining the optimal time from a positive screening fecal occult blood test to follow-up colonoscopy. We reviewed records of 231 consecutive primary care patients who received a colonoscopy within 18 months of a positive fecal occult blood test. We examined the relationship between time to colonoscopy and risk of neoplasia on colonoscopy using a logistic regression analysis adjusting for potential confounders such as age, race, and gender. The mean time to colonoscopy was 236 days. Longer time to colonoscopy (OR = 1.10, P = 0.01) and older age (OR 1.04, P = 0.01) were associated with higher odds of neoplasia. The association of time with advanced neoplasia was positive, but not statistically significant (OR 1.07, P = 0.14). In this study, a longer interval to colonoscopy after fecal occult blood test was associated with an increased risk of neoplasia. Determining the optimal interval for follow-up is desirable and will require larger studies.

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Acknowledgment

This study was funded in part by NIH T32 DK007568-17 (Dr Gellad). Dr. Fisher was supported by a VA HSR&D Career Development Award (CDA03-174). Dr. Provenzale was supported by an NIH K24 (DK002926-07). The authors have no relevant conflicts of interest to disclose.

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Authors and Affiliations

  1. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA

    Ziad F. Gellad, Daniel Almirall, Dawn Provenzale & Deborah A. Fisher

  2. Department of Medicine, Division of Gastroenterology, Duke University Medical Center, Box 3913, Durham, NC, 27710, USA

    Ziad F. Gellad, Dawn Provenzale & Deborah A. Fisher

  3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA

    Daniel Almirall

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  1. Ziad F. Gellad
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  2. Daniel Almirall
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  4. Deborah A. Fisher
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Correspondence to Ziad F. Gellad.

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The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

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Gellad, Z.F., Almirall, D., Provenzale, D. et al. Time from Positive Screening Fecal Occult Blood Test to Colonoscopy and Risk of Neoplasia. Dig Dis Sci 54, 2497–2502 (2009). https://doi.org/10.1007/s10620-008-0653-8

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  • DOI: https://doi.org/10.1007/s10620-008-0653-8

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