title: Time from positive screening fecal occult blood test to colonoscopy and risk of neoplasia.
abstract: There is no guideline defining the optimal time from a positive screening fecal occult blood test to follow-up colonoscopy. We reviewed records of 231 consecutive primary care patients who received a colonoscopy within 18 months of a positive fecal occult blood test. We examined the relationship between time to colonoscopy and risk of neoplasia on colonoscopy using a logistic regression analysis adjusting for potential confounders such as age, race, and gender. The mean time to colonoscopy was 236 days. Longer time to colonoscopy (OR = 1.10, P = 0.01) and older age (OR 1.04, P = 0.01) were associated with higher odds of neoplasia. The association of time with advanced neoplasia was positive, but not statistically significant (OR 1.07, P = 0.14). In this study, a longer interval to colonoscopy after fecal occult blood test was associated with an increased risk of neoplasia. Determining the optimal interval for follow-up is desirable and will require larger studies.
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27710, USA. z.gellad@duke.edu
authors.forename: Ziad F
authors.initials: ZF
authors.lastname: Gellad
authors.forename: Daniel
authors.initials: D
authors.lastname: Almirall
authors.forename: Dawn
authors.initials: D
authors.lastname: Provenzale
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Fisher
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors