Fecal Occult Blood Test Results Research Articles

Rectally obtained fecal samples can be used for fecal occult blood testing in dogs, and fecal immunochemical tests do not detect canine or feline blood.

The first objective was to determine if the sample collection method (naturally voided vs digital rectal examination collection) affected fecal occult blood test (FOBT) results. The second objective was to assess the ability of human fecal hemoglobin immunochemical tests to detect canine and feline blood. 308 privately owned dogs, healthy and sick. Guaiac FOBTs were performed on paired voided and rectally obtained canine fecal samples. The kappa statistic was used to assess agreement between the 2 collection methods, and a multivariate regression model was used to identify factors associated with a positive FOBT. Two fecal immunochemical tests (FITs; Hemosure One Step and OC-Light S) were tested with serially diluted human, canine, and feline blood. Voided and rectally obtained samples showed strong FOB-positivity agreement (k = 0.80), with 92.5% concordance and only 13/308 dogs negative on void but positive on rectal. Multivariate analysis showed dogs with gastrointestinal disease (P = .0008, rectal; P = .0001, void) were more likely and heavier dogs (P = .0037, rectal; P = .0022 void) were less likely to test FOBT positive. Health status, fasting status, NSAID use, and age were associated with FOBT results on univariate, but not multivariate, analysis. FITs did not detect canine or feline blood at any concentration while human blood performed as expected. Rectally obtained fecal samples can be reliably used for FOBTs. Human FITs may not be suitable for companion animals, but evaluation of other available tests is needed.

Asymptomatic intestinal tuberculosis of the terminal ileum diagnosed on colonoscopy: a case report and literature review.

Colonoscopy is useful in diagnosing intestinal tuberculosis. However, the terminal ileum is generally not examined during routine colonoscopy. Therefore, even with colonoscopy, the diagnosis can be missed in patients with lesions confined to the terminal ileum. Herein, we report the case of an asymptomatic patient with intestinal tuberculosis, in whom a colonoscope insertion into the terminal ileum led to the diagnosis. An asymptomatic 71-year-old man visited our hospital for a colonoscopy after a positive fecal occult blood test. Colonoscopy revealed diffuse edematous and erosive mucosa in the terminal ileum. Mycobacterium tuberculosis was detected by polymerase chain reaction and culture of biopsy specimens from the erosions, leading to the diagnosis of intestinal tuberculosis. The patient was treated with antitubercular agents for 6 months, and a follow-up colonoscopy revealed healing of the lesions. Asymptomatic intestinal tuberculosis may occasionally be detected on colonoscopy following a positive fecal occult blood test and is sometimes confined to the terminal ileum. Therefore, clinicians should consider intestinal tuberculosis in the differential diagnosis of the causes of positive fecal occult blood test results and perform colonoscopies, including observation of the terminal ileum.

Does Chinese herbal medicine (CHM) reduce colorectal adenoma (CRA) recurrence: protocol of a registry-based, cohort study and a qualitative interview

IntroductionColorectal adenoma (CRA) is a precancerous lesion for colorectal cancer. Endoscopic resection is the first-line treatment for CRA. However, CRA recurrence rate is high. This proposed study aims to determine...

Endoscopic findings and predictors of gastrointestinal lesions in children with iron deficiency anemia

Iron deficiency anemia (IDA) can be caused by occult gastrointestinal (GI) blood loss; however, the endoscopic findings in children with anemia are unclear. The study aimed to determine the frequency and factors related to lesions in children with IDA undergoing endoscopy. We retrospectively analyzed the clinical and endoscopic findings of children with a laboratory-based diagnosis of IDA. Of 58 patients, 36 (62.1%) had upper GI tract lesions, with erosive gastritis being the most common lesion. Further, 26 patients underwent concomitant colonoscopy, and 12 (46.2%) had lower GI tract lesions. Overall, 44 (75.9%) patients had lesions in either the upper or lower GI tract. Helicobacter pylori infection was detected in 13 patients (22.4%). Patients with lesions found by endoscopy had significantly lower hemoglobin level (8.9 vs. 10.0 g/dL, p = 0.047) and mean corpuscular volume (75.5 vs. 80.9 fL, p = 0.038). The proportion of patients with previous treatment for IDA was also higher in those with lesions on endoscopy. In multivariate analysis, age of ≥10 years (odds ratio [OR], 6.00; 95% confidence Interval [CI], 0.56–10.75) and positive fecal occult blood test (FOBT) findings (OR, 2.25; 95% CI, 0.14–4.52) were factors related to GI lesions. The presence of GI symptoms was not associated with GI lesions. A high proportion of GI lesions were found by endoscopy in children with IDA in this study. Endoscopy should be considered in children with IDA even without GI symptoms, especially in older children, and those with positive FOBT results.

A Pilot Colorectal Cancer Study Using Fecal Occult Blood Tests and Colonoscopy to Identify the Weaknesses of the Romanian Public Healthcare System before Implementing National Screening.

The objective of this study is to investigate the feasibility of colorectal cancer (CRC) screening in the absence of a national screening program using the resources provided by the Romanian healthcare system. Study participants were recruited from adult patients (over 18 years old) registered with a general practitioner from an urban area over a period of 3 years (October 2019 to September 2022). Patients were recruited when they came for a consult at their family physician's office. The study excluded patients with a medical history of colorectal cancer. Written consent was obtained from the patients who agreed to participate. Patients who agreed to participate were recommended to undergo a fecal occult blood test (FOBT). For those with a positive FOBT result, a colonoscopy was recommended. The study identified a need and willingness of patients to participate in CRC screening when they were informed about it, especially when it involved a noninvasive test such as FOB. We did not anticipate the refusal to perform FOBT in the public healthcare system because the recommendation was made by a GP. We identified a deficit of specialists that can perform colonoscopies in the public healthcare system, insufficient health education, and a lack of dedicated pathways for screening.

Diagnostic yield of stool culture and probable predictive factors.

Stool analysis is commonly performed to diagnose certain gastrointestinal diseases. The diagnostic yield of stool culture, a method of stool analysis, is variable worldwide and is unclear in the Kingdom of Saudi Arabia. This study was conducted to determine the diagnostic yield of stool culture from the year 2008 to 2020 and to determine the predictors for a positive stool culture. Furthermore, antibiotic susceptibility patterns of the detected copro-pathogens in the same time period were collected and studied. This is a retrospective case-control study in which patients' data was collected from the hospital's electronic health record. The results of all stool analyses performed from 2008 to 2020 and associated patients' characteristics were collected. Characteristics of cases with a positive stool culture were compared to the characteristics of those without to identify the predictors for positive stool cultures. Copro-pathogens were detected in 89.4% of cultured stool samples. Salmonella spp (1590/1775, 89.6%) was the most common organism followed by Shigella spp. (84/1775, 4.7%) and Campylobacter spp (45/1775, 2.5%). Male sex, the 1-5 age group, positive fecal occult blood test results, and positive stool leukocyte test results were associated with a positive stool culture result. Cultured copro-pathogens were highly sensitive to Trimethoprim/Sulfamethoxazole and Ampicillin. Stool analysis was found to be a test of high diagnostic yield. However, there is still a need for more studies on this subject with a focus on possible predictive factors for specific organisms.

Examining the Factors That Affect the Diagnosis of Patients with Positive Fecal Occult Blood Test Results.

Due to the threat of colorectal cancer (CRC) to health, Taiwan included the fecal occult blood test (FOBT) under preventive health services in 2010. We examined the factors that affect the diagnosis of people with positive FOBT results. Data were retrospectively collected from the CRC screening database. In the model predicting factors that affect the diagnosis of 89,046 people with positive FOBT results, the risks of disease in the CRC group were lower in medical institutions that conducted follow-up examinations in regions such as Northern Taiwan compared to that in Eastern Taiwan (p = 0.013); they were lower in the age group of 50 to 65 years than those in the age group of 71 to 75 years (p < 0.001, p = 0.016), and lower in the outpatient medical units that conducted follow-up examinations than those in the inpatient medical units by 0.565 times (p < 0.001, 95% CI: 0.493–0.647). Factors affecting the diagnosis of patients with positive FOBT results were gender, the region of the medical institution, medical unit for follow-up examinations, age, screening site, family history, type of follow-up examinations, and follow-up time. Therefore, the identification of characteristics of patients with positive FOBT results and the promotion of follow-up examination are important prevention strategies for CRC.

Factors influencing hospital stay duration for patients with mild ischemic colitis: a retrospective study

BackgroundIschemic colitis is the most prevalent ischemic injury of the gastrointestinal tract. The majority of patients with mild ischemic colitis usually achieve complete clinical recovery shortly. However, the predictors of longer hospital stay duration are unclear. This study aimed to evaluate the predictors of hospital stay duration for patients with mild ischemic colitis.MethodsWe retrospectively evaluated 100 patients with mild ischemic colitis between January 2010 and December 2020 at Xiangya Hospital (a tertiary care center). The clinical characteristics and therapeutic drugs of patients who were hospitalized for ≤ 8 days and ≥ 12 days were compared.ResultsOf the 100 patients included, 63 (63%) were hospitalized for ≤ 8 days and 37 (37%) were hospitalized for ≥ 12 days. Patients with cerebrovascular disease (29.7% vs. 11.1%, p = 0.019) and abdominal surgical history (29.7% vs. 7.9%, p = 0.004) were more likely to be hospitalized for ≥ 12 days than for ≤ 8 days. The d-dimer levels [0.78 (0.41–1.82) vs. 0.28 (0.16–0.73), p = 0.001] and positive fecal occult blood test results (86.5% vs. 60.3%, p = 0.006) were higher in patients who were hospitalized for ≥ 12 days than in those who were hospitalized for ≤ 8 days. Probiotic use was greater in patients hospitalized for ≤ 8 days (76.2% vs. 54.1%, p = 0.022). Multivariate analysis indicated that cerebrovascular disease (odds ratio [OR] = 4.585; 95% confidence interval [CI] 1.129–18.624; p = 0.033), abdominal surgical history (OR = 4.551; 95% CI 1.060–19.546; p = 0.042), higher d-dimer levels (OR = 1.928; 95% CI 1.024–3.632; p = 0.042), and higher positive fecal occult blood test results (OR = 7.211; 95% CI 1.929–26.953; p = 0.003) were associated with longer hospital stays.ConclusionCerebrovascular disease, abdominal surgical history, higher d-dimer levels, and higher positive fecal occult blood test results are independent and significant factors that influence longer hospital stays for patients with mild ischemic colitis. Probiotics helped reduce hospital stay in these patients.

The yield of fecal occult blood testing as a screening tool for colon cancer in a primary care setting.

The most common cancer among men and the third most common among women in Saudi Arabia is colon cancer. This study aimed to evaluate the yield of the fecal occult blood test (FOBT) used as a screening tool for colon cancer. Medical records of all patients above the age of 50 years who had visited the Family Medicine clinic at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia and who had undergone the FOBT screening between January 2002 and March 2017 were retrospectively reviewed. We collected patients' demographic data, FOBT results, and colonoscopy pathology reports results. Data were analyzed using the Statistical Package for Social Science Version 25 (IBM Corp., Armonk, NY, USA). We included 2179 patients in this study. The mean age was 59.8 ± 8 years. As a result of the FOBT screening, 19.7% of the patients had a positive FOBT. Colon cancer accounted for 3.5% of all abnormal colonoscopy pathology reports. The Saudi age-standardized incidence rate (ASIR) in our study was 26.56 per 100,000 persons. FOBT is a feasible tool that can be used for colon cancer screening in primary care settings. The Saudi ASIR in our study was higher than the Saudi Cancer Registry, but it was still lower in comparison to other countries. We recommend the establishment of a national community-based colon cancer screening program.

Анализ результатов по калу на скрытую кровь при диспансеризации населения в районах Республики Татарстан за 2018-2019 гг.

Purpose. The work was aimed at analyzing the fecal occult blood (FOB) test results obtained during oncoscreening for colorectal cancer due to prophylactic medical examination of the population of some municipal districts of the Republic of Tatarstan (RT) in 2018 and 2019, as well as assessing the distribution of the examined patients by gender, age, and pathology detectability for different RT regions. Material and methods. Materials for examination were stool samples taken into special vials manufactured by Sentinel Diagnostics (Italy). Materials were taken in laboratories of regional hospitals and outpatient departments. Fecal occult blood tests were performed on a AU-680 and AU-480 Beckman Coulter biochemical analyzers in the RT oncology dispensary laboratory by the immunochemical (immunoturbodimetric latex) method for quantitative determination of hemoglobin content in the stool. The reagents were supplied by Sentinel FOB Gold NG. Reference values were 0–50 ng/ml. Results. A comparative analysis of the data for two years showed the increase in inclusion of population into prophylactic medical examination from 4,2% up to 6,9% predominantly thanks to women, as well as the decrease in the revealed FOB pathology from 8,7% down to 7,7% both within men and women. The maximum increase in the amount of the examined population from 8,5% in 2018 up to 18,3% in 2019 occurred in the Atninsky municipal district. The averaged maximum abnormal level within women (12,1%) was revealed in the Vysokogorsky municipal district, but within men (16,0%) — in the Sabinsky municipal district. A two-fold increase in the abnormal level within men occurred in the Alkeyevsky, Buinsky, and Sarmanovsky municipal districts, but within women — in the Kaybitsky municipal district. Most frequently, for every fourth patient in average, exceeded reference values were observed for the total age of 60-69 and more then 70. For the age of 50-59, a permanently low abnormal level was revealed both within men (2% in 2018 and 3% in 2019) and women (3% and 3% respectively). The abnormal level over the average for the Republic within men of the age of 40-49 was revealed in seven municipal districts. The abnormal level over the average was observed within all population of the age of 40 to 50 in the Apastovsky municipal district. A positive dynamics (a decrease in pathology level below the average) within population of all age groups was observed in four municipal districts (the Drozhzhanovsky, Rybno-Slobodsky, Sarmanovsky, and Mamadyshsky districts).

Factors affecting the follow-up time after a positive result in the fecal occult blood test.

In 2010, Taiwan included the fecal occult blood test (FOBT) under preventive health insurance services. For patients whose test positive, receiving follow-ups is paramount. This study investigated factors affecting the follow-up time of these patients. This retrospective study used data from the colorectal cancer screening archives. The study period was from 2010 to 2013, and the subjects were 50–75-year-old persons who tested positive for FOBT. The t test, one-way ANOVA, and multiple regression were performed to address the differences in the mean tracking period between variables such as the population’s demographic characteristics. The mean follow-up time for the 98,482 participants whose screening results were positive exhibited significant differences (p < 0.001) according to medical unit region and classification, age, screening location, family history, examination method, and diagnosis. The model predicting the mean follow-up time predicted a period of 10.079 days longer for those whose hospital was on an offshore island than that of those whose hospital was in the eastern regions. The follow-up time was 1.257 days shorter for people who were inpatients than those who were outpatients and was 8.902 days longer for people who underwent double contrast barium enema plus flexible sigmoidoscopy than those who underwent other examination methods. Patients with a family history of colorectal cancer and those whose examination results indicated cancer had a follow-up time of 2.562 and 2.476 days shorter than those who did not know their family history and those with other results, respectively. Factors affecting the follow-up time of people whose FOBT results were positive consisted of the location and classification of the follow-up institution, age, screening location, family history, examination method, and diagnosis. This provides valuable references for improving the cancer screening program.

Colorectal endometriosis with a large polypoid lesion

A 39-year-old woman was referred to our hospital because of a positive fecal occult blood test result. She had undergone uterine myomectomy 6 years earlier, and she had been treated with levothyroxine for hypothyroidism after thyroidectomy for Graves’s disease. A physical examination revealed a left-sided abdominal mass without tenderness. A laboratory test showed that the levels of serum tumor markers were within normal range. A barium enema revealed a 4-cm protruding lesion in the descending colon (A). The lesion looked like a submucosal tumor with reddish mucosa and dilatated vessels (B). Magnifying endoscopy with crystal violet staining showed 2 types of pit pattern: most was regular and rounded, whereas a small area had an enlarged and irregular pit pattern (C). Surgical histopathologic examination confirmed that the protruding lesion was composed of endometrial glands and stroma surrounded by smooth muscle bundles (D, H&E, orig. mag. ×40). The results of testing for immunohistochemistry, estrogen receptor (ER), and progesterone receptor were positive. Therefore, we diagnosed polypoid endometriosis. Retrospectively, a biopsy specimen from the lesion with irregular pits showed that a few glands were positive for ER (E, Immunohistochemistry for ER, orig. mag. ×200). Colorectal endometriosis usually presents as eccentric wall thickening and surface nodularities, and diagnosis by endoscopic biopsy is difficult. Our case suggests that magnifying endoscopy is useful for diagnosis with target biopsy for intestinal endometriosis.

Intestinal Spirochetosis

A 49-year-old heterosexual man presented to our outpatient clinic after a positive fecal occult blood test result. He had no remarkable past medical history and reported neither weight loss nor bowel symptoms. Colonoscopy showed a small erosive lesion in the cecum (Figure A), and biopsies were performed. Light microscopy revealed a band of spirochetes resembling a “false brush border” that was adherent to the border of the epithelial layer (Figure B, arrows; hematoxylin-eosin staining). This was highlighted by immunostaining for Treponema pallidum (Figure C, arrows).

Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study.

Colorectal cancer (CRC) is a common disease and one of the leading causes of cancer deaths worldwide. This retrospective cohort study evaluated the risk of developing CRC in people with hemorrhoids. Using Taiwan’s National Health Insurance Research Database, we established three sets of retrospective study cohorts with and without hemorrhoids. The first set of cohorts were matched by sex and age, the second set of cohorts were matched by propensity score without including colonoscopies, and the third set of cohorts were matched by propensity score with colonoscopies, colorectal adenomas, and appendectomies included. In the second set of cohorts, 36,864 persons with hemorrhoids that were diagnosed from 2000 to 2010 and a comparison cohort, with the same size and matched by propensity score, were established and followed up to the end of 2011 to assess the incidence and Cox proportional regression-measured hazard ratio (HR) of CRC. The overall incidence rate of CRC was 2.39 times greater in the hemorrhoid cohort than it was in the comparison cohort (1.29 vs. 0.54 per 1000 person-years), with a multivariable model measured adjusted HR of 2.18 (95% CI = 1.78–2.67) after controlling for sex, age, and comorbidity. Further analysis on the CRC incidence rates among colorectal sites revealed higher incidence rates at the rectum and sigmoid than at other sites, with adjusted HRs 2.20 (95% CI = 1.48–3.28) and 1.79 (95% CI = 1.06–3.02), respectively. The overall incidence rates of both cohorts were similar in the first and second sets of cohorts, whereas the rate was lower in the third set of hemorrhoid cohorts than in the respective comparison cohorts, probably because of overmatching. Our findings suggest that patients with hemorrhoids were at an elevated risk of developing CRC. Colonoscopy may be strongly suggested for identifying CRC among those with hemorrhoids, especially if they have received a positive fecal occult blood test result.

Adherence to follow-up examination after positive fecal occult blood test results affects colorectal cancer mortality: A Korea population-based cohort study

BackgroundThe impact of adherence to follow-up examination after a fecal occult blood test (FOBT) remains ill-defined. AimTo evaluate the impact of adherence to the follow-up examination on clinical outcomes in individuals with positive FOBT results. MethodsThis was a retrospective cohort study involving Korean individuals aged 50 years or older who participated in the National Cancer Screening Program for CRC from 2009 to 2010. Individuals who underwent a confirmative examination within a year after positive FOBT results were included in compliant group, and those who did not were included in non-compliant group. The incidence and stage of CRC, and 5-year survival were compared between two groups. Results5,914 were diagnosed with CRC in the compliant group and 2,973 in the non-compliant group. The proportion of advanced-stage CRC was significantly higher in the non-compliant group (localized CRC 44.6% vs. 36.7% and distant CRC 8.7% vs. 12.5%, p< 0.0001). The survival probability within 5 years was 71.0% in the non-compliant group and 85.9% in the compliant group (hazard ratio 1.70, 95% CI, 1.52–1.90, p< 0.001). ConclusionIndividuals who underwent follow-up examination 1 year or more after positive FOBT had a lower survival rate compared with that in those who underwent examination within 1 year.

A Novel Insight Into Fecal Occult Blood Test for the Management of Gastric Cancer: Complication, Survival, and Chemotherapy Benefit After R0 Resection.

BackgroundPrevious studies have shown that the all-cause mortality and non-colorectal cancer mortality of patients with fecal occult blood test (FOBT) positivity are significantly increased, implying that FOBT results may have more prognostic value.MethodsRetrospective analysis was performed for gastric cancer (GC) patients who underwent R0 gastrectomy from July 2007 to July 2014 at our hospital. Propensity score matching (PSM) was used to reduce confounding bias and a computerized technique for the nearest available score matching without replacement was applied. The cumulative survival rate was calculated using the Kaplan-Meier method and a log-rank test. Cox proportional hazards regression and logistic regression was used to determine the independent prognostic factors associated with survival and postoperative complications, respectively. The expression level of tumor-associated macrophages (TAMs) and proinflammatory cytokines (TNF-α, IL-6) were evaluated by immunohistochemical (IHC).ResultsA total of 3,003 patients were included and 246 patients (8.2%) were in preoperative FOBT positive status. There was no significant difference in demographic data between preoperative FOBT positive and negative group after a 1:4 PSM. The overall postoperative complications, major complications, and anastomotic leakage were significantly higher in the preoperative FOBT-positive group than in the preoperative FOBT-negative group. Moreover, preoperative FOBT-positivity was an independent risk factor for 5-year overall survival (OS) (HR: 1.32, p = 0.005). For stage II/III patients, the postoperative adjuvant chemotherapy (PAC) benefit was found in preoperative FOBT-negative group (5-year OS: 49.9 vs. 36.8%, p = 0.001), whereas the PAC benefit was lost in preoperative FOBT-positive groups (5-year OS: 40.8 vs. 37.7% p = 0.896). Finally, IHC found that preoperative FOBT-positivity in patients was significantly associated with higher TAMs infiltration and higher expression of IL-6 and TNF-α in tumor tissues than in the preoperative FOBT-negative group.ConclusionAs a simple and low-cost method, preoperative FOBT results can predict both complications and survival after R0 gastrectomy for GC. More importantly, stage II/III GC patients with FOBT-positive seem not benefit from PAC alone. Further exploration is warranted.

Positive Fecal Occult Blood Test is a Predictive Factor for Gastrointestinal Bleeding after Capsule Endoscopy in Patients with Unexplained Iron Deficiency Anemia: A Korean Multicenter CAPENTRY Study.

Background/AimsCapsule endoscopy (CE) is recommended as the primary method for the evaluation of unexplained anemia. This study aimed to assess the diagnostic yield of CE in patients with unexplained iron deficiency anemia (IDA) without overt bleeding, and to evaluate their long-term outcomes and related clinical factors. MethodsData of patients who underwent CE for the evaluation of IDA were reviewed from a CE registry in Korea. Additional clinical data were collected by the involved investigators of each hospital through a review of medical records. ResultsAmong a total of 144 patients, the diagnostic yield of CE was 34%. Gastrointestinal (GI) bleeding was found in 6.3% (n=9) of the patients (occult bleeding in four patients and overt bleeding in five patients) during a mean follow-up of 17.8 months. Patients with a positive fecal occult blood test (FOBT) result at the initial diagnosis had a higher rate of GI bleeding after CE (p=0.004). In addition, a positive FOBT result was the only independent predictive factor for GI bleeding (hazard ratio, 5.30; 95% confidence interval, 1.41–19.85; p=0.013). ConclusionsPositive FOBT is a predictive factor for GI bleeding during follow-up after CE in patients with unexplained IDA without overt bleeding. Thus, patients with positive FOBT need to be more closely followed up.

S1228 Fecal Occult Blood Testing Associated With Delayed Hospital Discharge: A Quality Improvement Study

INTRODUCTION: Fecal occult blood testing (FOBT) is a cheap test that is commonly used in outpatient and inpatient settings. The primary purpose of FOBT is to screen for colorectal cancer in an outpatient setting, as recommended by the US preventive services task force. FOBT inpatient use has not been validated. On the contrary, many reports advise against the inpatient use of FOBT. The impact of performing FOBT on hospitalization outcomes such as length of stay has (LOS) been sufficiently studied in literature. We aimed to assess whether our inpatient use of FOBT is associated with increased LOS in hospitalized patients with GI bleeding or iron deficiency anemia. METHODS: Adult inpatients from January 2016 until June 2020 with ICD-10-CM diagnoses pertaining to GI bleeding and/or iron deficiency anemia were included. The primary outcome was LOS. The secondary outcome was mortality. Variables were compared between FOBT ordered VS not ordered and FOBT positive VS negative. Standard statistical tests using Chi-square, Student t-test, Mann-Whitney U test, survival analysis, and multivariate linear regression were used. RESULTS: 4401 hospitalizations with GI bleeding and/or iron deficiency anemia were included. Mean age was 66 ± 16 years. Females represented 56.4%. GI bleeding was present in 2551 (58%) hospitalizations while iron deficiency anemia in 2256 (51.3%). FOBT was ordered in 832 (18.9%) and performed in 540 (12.3%). Ordering FOBT was associated with increased LOS (median 5.5 VS 4.4, P < 0.01) and no reduction in inpatient mortality (Table 1). Figure 1 illustrates that patients with FOBT-ordered stay longer in hospital prior to discharge. Positive FOBT occurred in 401 (74%) of performed tests. Patients with positive FOBT had higher mortality compared to negative FOBT (3.7% VS 0%, P = 0.02) (Table 2). CONCLUSION: FOBT is not indicated for inpatient settings. Although a positive FOBT result is associated with higher mortality, ordering FOBT should not delay obtaining early gastroenterology consultation and endoscopic treatment if indicated. Educational interventions should be implemented to decrease inappropriate inpatient use of FOBT testing.Table 1.: Comparison of baseline characteristics and outcomes based on FOBT order statusFigure 1.: A survival analysis plot comparing hospital discharges based on FOBT order status.Table 2.: Comparison of hospitalization outcomes based on FOBT test results

Preferences for different diagnostic modalities to follow up abnormal colorectal cancer screening results: a hypothetical vignette study

ObjectivesIn England, a significant proportion of people who take part in the national bowel cancer screening programme (BCSP) and have a positive faecal occult blood test (FOBt) result, do not...

Colonoscopy in patients with psoriasis before the initiation of treatment with biological agents.

Psoriasis may lead to subsequent colorectal cancer, since chronic systemic inflammation is the common etiologic factor in both psoriasis and colorectal cancer. It is a matter of dispute whether biological agents used in the treatment of psoriasis cause predisposition to colorectal cancer as a result of their immunosuppressive effect. Medical records of psoriasis patients who underwent colonoscopy before biological agents were reviewed. Colonoscopy was performed in all patients who were aged 50 years and older and in patients younger than 50, if they had positive fecal occult blood test results. The study included 95 patients between the age of 34 to 84. Colonoscopy results revealed tubular adenoma in 16 (16.8%) patients, hyperplastic polyps in 7 (7.4%) patients, villous adenoma in 1 (1.1%) patient, and tubulovillous adenoma in 1 (1.1%) patient. Two patients were diagnosed with colon cancer detected by a former colonoscopy, which was recommended by their dermatologist before the biological agent treatment plan. These results revealed that adenomatous polyps which can evolve to colon adenocarcinoma were the most frequent polyp type in patients with psoriasis. We suggest that routine colonoscopy should be performed before the initiation of biological therapy in psoriasis patients who are aged 50 years old and over.