Department of Internal Medicine, Amitahealth Saint Joseph Hospital in Affiliation with University of Illinois College of Medicine, Chicago, Il, 60657, USA.
Division of Hospital Medicine, University of Kentucky, Lexington, KY, 40536, USA.
BMC Gastroenterol. 2019 Sep 3;19(1):161. doi: 10.1186/s12876-019-1079-9.
The Fecal Occult Blood Test (FOBT) is one of the diagnostic modalities indicated for screening patients for Colorectal Cancer (CRC). Despite being approved only for screening for CRC, numerous studies in the past have illustrated misuse of the FOBT. We examined utilization of the FOBT for patients admitted to a community teaching hospital.
The study was conducted at Saint Joseph Hospital, Chicago USA. A retrospective review of Electronic Medical Records (EMRs) of patients admitted from January 2016 to December 2017 was performed.
We reviewed the EMRs of 729 patients who received the stool testing for occult blood (FOBT). All tests (100%) were carried out for purposes other than CRC screening. Anemia (38%) was the most common reason documented for carrying out the FOBT. Further, 88% of the tests were ordered on patients who either did not fulfill CRC screening criteria or had other contraindications for testing. Usage of contraindicated medication was the most important factor (58% of patients) that made the candidates ineligible for testing. A total 73 Colonoscopies were ordered for patients who received the test inappropriately with a resulting low yield (0.47%) of CRC diagnosis.
The stool occult blood test continues to be utilized for reasons other than CRC screening. Majority of patients who underwent the test were not suitable candidates due to the presence of contraindications for testing. Unsuitable FOBT testing led to further unnecessary investigations.
粪便潜血试验（FOBT）是用于筛查结直肠癌（CRC）患者的诊断方法之一。尽管仅批准用于 CRC 筛查，但过去的许多研究表明，FOBT 的使用存在不当。我们检查了社区教学医院住院患者的 FOBT 使用情况。
该研究在美国芝加哥的圣约瑟夫医院进行。对 2016 年 1 月至 2017 年 12 月期间入院患者的电子病历（EMR）进行了回顾性审查。
我们回顾了 729 名接受粪便潜血（FOBT）检测的患者的 EMR。所有检测（100%）均用于 CRC 筛查以外的目的。贫血（38%）是记录进行 FOBT 的最常见原因。此外，88%的检测是在未满足 CRC 筛查标准或有其他检测禁忌症的患者中进行的。禁忌药物的使用是使患者不适合检测的最重要因素（58%的患者）。在因不合适的检测而接受检测的患者中，共进行了 73 次结肠镜检查，CRC 诊断的检出率很低（0.47%）。
FOBT 继续用于 CRC 筛查以外的原因。由于检测的禁忌症，大多数接受检测的患者不适合接受检测。不合适的 FOBT 检测导致了进一步的不必要的检查。
