Dr Charles Scales and colleagues examined the clinical utilization of digital rectal examination and fecal occult blood testing at hospital admission.
Digital rectal examination at the time of hospital admission is frequently accompanied by fecal occult blood testing.
However, the utility of digital rectal examination with fecal occult blood testing in this setting is unknown.
The study cohort comprised consecutive admissions to an internal medicine service over a 3-month period.
The investigative team compared patient characteristics for subjects by digital rectal examination performance and fecal occult blood testing result.
Follow-up endoscopic procedures within 1 year of admission were recorded.
Complete data were available for 806 of 832 patients.
|52% with positive fecal occult blood tests had no history of GI bleeds|
|Journal of Clinical Gastroenterology|
The team reported that 348 patients underwent digital rectal examination on admission.
The investigators noted that patients undergoing digital rectal examination/fecal occult blood testing were older.
Patients with gastrointestinal (GI) bleeding or a history of GI bleeding were more likely to undergo digital rectal examination/fecal occult blood testing.
The team found that among 130 patients with a positive fecal occult blood test, 52% had no history of GI bleeding symptoms.
The investigators observed that these patients were less likely to undergo follow-up examination than patients with a positive fecal occult blood test.
In addition, the team noted that these patients were less likely to attend follow-up examinations than those with a history of GI bleeding symptoms.
Dr Scales' team comments, “In this cohort, patients with a past history of GI disease or symptoms were more likely to undergo fecal occult blood testing.”
“Follow-up evaluation of positive fecal occult blood testing in the absence of GI bleeding symptoms was very low.”
“Low utilization and follow-up rates may limit the utility of admission digital rectal examination with fecal occult blood testing for cancer screening.”