Many Physicians Using Inappropriate FOBT Methods

Home fecal occult blood tests recommended for cancer screening, but in-office tests common

THURSDAY, April 15 (HealthDay News) -- Many physicians who use the fecal occult blood test (FOBT) for colorectal cancer screening administer the test in-office rather than using home-based tests, which are recommended by national guidelines, according to research published online April 10 in the Journal of General Internal Medicine.

Marion R. Nadel, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues conducted a cross-sectional national survey of 1,134 primary care physicians who reported ordering or performing FOBTs in 2006 to 2007 to determine whether FOBT screening methods have improved since 1999 to 2000.

The researchers found that a minority -- 22 and 8.9 percent -- of physicians reported using higher sensitivity guaiac and immunochemical tests, respectively; most used standard guaiac tests. Although single-specimen, in-office testing is considered inappropriate for screening, 24.9 percent reported using only in-office tests, and 52.9 percent reported using both in-office and home tests. Follow-up recommendations after a positive test, however, improved, with only 17.8 percent of physicians recommending another FOBT after positive findings, and only 6.6 percent using tests other than colonoscopy for diagnostic work-up.

"Many physicians continue to use inappropriate methods to screen for fecal occult blood. Intensified efforts to inform physicians of recommended technique and promote the use of tracking systems are needed," the authors write.

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