title: Warfarin Use During Fecal Occult Blood Testing: A Meta-Analysis.
abstract: BACKGROUND
  Fecal occult blood testing (FOBT) is a widely used screening test for colorectal cancer (CRC). Given the limited data about the effects of warfarin on FOBT are inconclusive, current screening guidelines for CRC do not address whether warfarin should be discontinued before FOBT. Therefore, we conducted a meta-analysis to evaluate the influence of warfarin on the yield of FOBT.
  
  
  METHODS
  Multiple medical databases were searched (April 2011). Studies examining the use of warfarin versus no warfarin for FOBT were included. Meta-analysis for the effect of warfarin or no warfarin for FOBT was performed by calculating pooled estimates of colonoscopy findings and detection of neoplasia, any adenoma, advanced adenoma, or colon cancer by odds ratio (OR) with fixed and random effects model. RevMan 5.1 was utilized for statistical analysis.
  
  
  RESULTS
  Five studies (N = 11,244) met the inclusion criteria. No statistically significant difference was noted between FOBT with or without warfarin for colonoscopy findings (OR 0.88; 95% CI: 0.48 - 1.62, P = 0.67) or detection of neoplasia (OR 0.88; 95% CI: 0.58 - 1.35, P = 0.57), any adenoma (OR 1.08; 95% CI: 0.73 - 1.58, P = 0.71), advanced adenoma (OR 1.07; 95% CI: 0.69 - 1.65, P = 0.78), and colon cancer (OR 0.69; 95% CI: 0.38 - 1.23, P = 0.21).
  
  
  CONCLUSIONS
  Among patients with positive FOBT, the yield of colonoscopy appears not to be altered by warfarin use.
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Imran
authors: I
authors: Ashraf
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Shafaq
authors: S
authors: Paracha
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Saif-Ur-Rahman
authors: SU
authors: Paracha
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Murtaza
authors: M
authors: Arif
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Abhishek
authors: A
authors: Choudhary
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Jonathan D
authors: JD
authors: Godfrey
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Robert E
authors: RE
authors: Clark
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Obai
authors: O
authors: Abdullah
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Michelle L
authors: ML
authors: Matteson
authors: OSF MG Gastroenterology, 2805 N. Knoxville Avenue, Peoria, IL 61604, USA.
authors: Srinivas R
authors: SR
authors: Puli
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Jamal A
authors: JA
authors: Ibdah
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Ousama
authors: O
authors: Dabbagh
authors: Five Hospital Drive, Department of Internal Medicine, University of Missouri - Columbia, Columbia, MO 65212, USA.
authors: Matthew L
authors: ML
authors: Bechtold
keywords: Colorectal cancer; Fecal occult blood test; Meta-analysis; Warfarin