Gastroenterologists’ Practice Patterns for Positive Fecal Occult Blood Test

• DOI: 10.1097/mcg.0b013e31828f1c8d
• Publication Date: 2013-04-30T12:50:04Z
• Authors: John J. Kim; Alexander Han; Arthur W. Yan; David Cao; Loren Laine
• Keywords: Fecal occult blood; Esophagogastroduodenoscopy

To evaluate gastroenterologists' use of esophagogastroduodenoscopy (EGD) for positive fecal occult blood test (FOBT).Colonoscopy is recommended when an FOBT performed colorectal cancer screening positive. Guidelines suggest no further evaluation if anemia and gastrointestinal (GI) symptoms are absent.Online surveys included 4 vignettes: in average-risk adults 50 years age or older with/without iron-deficiency upper GI symptoms. For each scenario, respondents were asked they would perform colonoscopy only, EGD colonoscopy+EGD on same day, followed by different day was negative.Surveys returned 778 (11%) 7094 potential responders. In patients without symptoms, 65% only; 35% added (9% 25% day). 91% with anemia, 96% 100% anemia+symptoms. alone (no anemia), multivariate analysis revealed fear litigation as the primary factor associated adding to (odds ratio=4.1; 95% confidence interval, 2.3-7.3). When EGD+colonoscopy planned FOBT, private practice performing a ratio=6.3; 2.9-13.5 versus academic setting).One third gastroenterologists addition alone. Fear most important deciding whether add colonoscopy. both procedures planned, more likely be days setting than setting.