title: Annual Fecal Occult Blood Testing can be Safely Suspended for up to 5 Years After a Negative Colonoscopy in Asymptomatic Average-Risk Patients.
abstract: OBJECTIVE
  Annual fecal occult blood testing (FOBT) is often continued in patients who have had a recent negative colonoscopy, despite recommendations to the contrary. This prospective study aimed to determine the proportion of patients with a positive FOBT who had adenomas and cancers on colonoscopy stratified according to the duration of time since the last negative colonoscopy.
  
  
  METHODS
  A total of 1,119 asymptomatic average-risk patients ≥50 years of age referred for a positive FOBT were prospectively identified and stratified by the duration of time since the last colonoscopy (never, >10 years, 5-10 years, or <5 years). The proportion of patients in each category with adenomas of any size, adenomas ≥10 mm, advanced neoplasms, and cancers was assessed.
  
  
  RESULTS
  The mean age (68.9±9.6 years), sex (95.2% male), and race (48.1% white, 32.1% black, 15.6% Hispanic, and 4.2% other) did not differ between the four groups. Overall, adenomas of any size were detected in 42.8% of patients, adenomas ≥10 mm in 14.7%, advanced neoplasms in 20.7%, and cancers in 7.3%. Advanced neoplasms were detected in 30.4% of patients who have never had a colonoscopy, 27% in those who have had one greater than 10 years prior, 10.0% in 5-10 years prior, and 1.1% in less than 5 years prior.
  
  
  CONCLUSIONS
  In asymptomatic average-risk patients with a negative colonoscopy within the last 5 years, the prevalence of adenomas is low, and no patient was diagnosed with cancer. These findings support the CDC recommendations to suspend annual FOBT for up to 5 years after a negative colonoscopy.
authors.affiliation: Division of Gastroenterology, VA New York Harbor Healthcare System, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Gastroenterology, VA New York Harbor Healthcare System, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Finkelstein
authors.affiliation: Division of Gastroenterology, VA New York Harbor Healthcare System, NYU Langone Medical Center, New York, New York, USA.
authors.forename: Fritz
authors.initials: F
authors.lastname: François
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death / Q000639:trends; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009780:Occult Blood; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors