Diagnostic Fecal Occult Blood Testing in Hospitalized and Emergency Department Patients: Time for Change?

Objective To examine the use of fecal occult blood testing in inpatients and in those presenting to the emergency department. Methods We retrieved all fecal occult blood tests (FOBTs) conducted over a 3 year period, gastrointestinal endoscopic studies, and diagnoses of digestive-tract malignant neop...

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Bibliographic Details
Published in:Laboratory medicine 2018-11, Vol.49 (4), p.385-392
Main Authors: Cuthbert, Jennifer A, Hashim, Ibrahim A
Format: Article
Language:English
Subjects:
Blood tests
Endoscopy
Feces
Home medical tests
Medical diagnosis
Tumors
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Summary:Objective To examine the use of fecal occult blood testing in inpatients and in those presenting to the emergency department. Methods We retrieved all fecal occult blood tests (FOBTs) conducted over a 3 year period, gastrointestinal endoscopic studies, and diagnoses of digestive-tract malignant neoplasms. Scheduling reasons and procedure results for all gastrointestinal endoscopies scheduled within 30 days after the FOBT result became available were recorded. Results A total of 5028 FOBTs were obtained during the 3-year period. Half of the diagnostic endoscopic procedures (n = 957) completed within 30 days of FOBT followed a negative test result. The few reasons for scheduling endoscopic procedures included a positive FOBT result. During follow-up, 17 new diagnoses of digestive-tract malignant neoplasms were made, and 8 of 17 patients had 1 or more positive FOBT result. Conclusions The results of FOBTs, by themselves, are rarely used for patient management. Eliminating the routine diagnostic use of FOBTs in those settings would not compromise patient care.
ISSN:0007-5027
1943-7730
DOI:10.1093/labmed/lmy010