Study: Many Patients Get No Follow-Up After Blood Is Found in Stool

Almost 50 percent of patients do not have a follow-up examination after blood is found in their stool during colon cancer screenings, primarily because their physician doesn't recommend it, according to researchers at Jefferson Medical College in Philadelphia.

While it is commonly assumed that the low rate of follow-up is due to a patient's reluctance to have tests such as colonoscopies, a study of 544 patients who had positive results on their fecal occult blood tests (FOBT) revealed that physicians actually had the greatest influence on whether the patients received further testing, according to Dr. Nadeem A. Baig of Jefferson Medical College.

Almost half of the patients in the study with a positive FOBT did not have a colonoscopy or a flexible sigmoidoscopy. Ten percent of them refused the testing, but 39 percent didn't have the testing per their physician's advice, he said.

"Many patients don't have the appropriate follow-up," said Baig said.

Researchers say they are not surprised that many patients with a positive result on their fecal occult blood tests (FOBT) do not undergo more testing, according to the study presented at the Digestive Diseases Week annual meeting in Atlanta.

Some of the physicians who were surveyed for the study said that the positive FOBT tests were probably due to medications the patients was taking or to another medical condition. Other physicians were concerned about recommending the follow-up testing to patients with other medical illnesses. Some physicians, however, made decisions that did not seem to meet current standards, according to Baig.

Researchers suggest that doctors need more training on when to recommend colorectal screening, as there are very few instances when a positive FOBT should not be investigated with additional screening.

A new study is underway to test the effects of educating physicians about screening guidelines, according to Baig.

Other sources: Reuters