ArticleArchives of internal medicine2011
Lack of follow-up after fecal occult blood testing in older adults: inappropriate screening or failure to follow up?
Article in Archives of internal medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Interventions to Improve Follow-up of Positive Results on Fecal Blood Tests: A Systematic Review.Annals of internal medicine · 2017Pooled it
- Prospective Cohort study of Predictors of Follow-Up Diagnostic Colonoscopy from a Pragmatic Trial of FIT Screening.Scientific reports · 2020Trial
- System-Wide Implementation of Colorectal Cancer Screening in a Value-Based Care Setting.Journal of general internal medicine · 2026Observational
- Predictors of gastrointestinal malignant tumors in fecal occult blood positive individuals prior to percutaneous coronary intervention: a Nomogram-based approach.Open medicine (Warsaw, Poland) · 2026Article
- Optimal Approach to Colorectal Cancer Screening.Gastroenterology & hepatology · 2025Article
- Patterns of Care Following a Positive Fecal Blood Test for Colorectal Cancer: A Mixed Methods Study.Journal of general internal medicine · 2024Article
- Article
- Disparities in Colorectal Cancer Screening Practices in a Midwest Urban Safety-Net Healthcare System.Digestive diseases and sciences · 2021Article
- Primary care clinicians' perceptions of colorectal cancer screening tests for older adults.Preventive medicine reports · 2021Article
- High Rate of Inappropriate Fecal Immunochemical Testing at a Large Veterans Affairs Health Care System.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2021Article
- Implementing a multilevel intervention to accelerate colorectal cancer screening and follow-up in federally qualified health centers using a stepped wedge design: a study protocol.Implementation science : IS · 2020Article
- Article
- Making FIT Count: Maximizing Appropriate Use of the Fecal Immunochemical Test for Colorectal Cancer Screening Programs.Journal of general internal medicine · 2020Article
- Trends in Wait Time for Outpatient Colonoscopy in the Veterans Health Administration, 2008-2015.Journal of general internal medicine · 2020Article
- Clinical Factors Associated with Adherence to the Follow-Up Examination after Positive Fecal Occult Blood Test in National Colorectal Cancer Screening.Journal of clinical medicine · 2020Article
- Preference and Experience of Colonic Examination for Participants Presenting to Hospitals with a Positive Fecal Immunochemical Test Result.Patient preference and adherence · 2020Article
- Assessing adherence and cost-benefit of colorectal cancer screening for accountable providers.Proceedings (Baylor University. Medical Center) · 2019Article
- Strategies to Improve Follow-up After Positive Fecal Immunochemical Tests in a Community-Based Setting: A Mixed-Methods Study.Clinical and translational gastroenterology · 2019Article
- Modifiable Failures in the Colorectal Cancer Screening Process and Their Association With Risk of Death.Gastroenterology · 2019Article
- Reasons For Lack of Follow-up Colonoscopy Among Persons With A Positive Fecal Occult Blood Test Result: A Qualitative Study.The American journal of gastroenterology · 2018Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIt is unclear whether lack of follow-up after screening fecal occult blood testing (FOBT) in older adults is due to screening patients whose comorbidity or preferences do not permit follow-up vs failure to complete follow-up in healthy patients.
methodsA prospective cohort study of 2410 patients 70 years or older screened with FOBT was conducted at 4 Veteran Affairs (VA) medical centers from January 1 to December 31, 2001. The main outcome measure was receipt of follow-up within 1 year of FOBT based on national VA and Medicare data. For patients with positive FOBT results, age and Charlson comorbidity scores were evaluated as potential predictors of receiving a complete colon evaluation (colonoscopy or sigmoidoscopy plus barium enema), and medical records were reviewed to determine reasons for lack of follow-up.
resultsA total of 212 patients (9%) had positive FOBT results; 42% received a complete colon evaluation within 1 year. Age and comorbidity were not associated with receipt of a complete follow-up, which was similar among patients 70 to 74 years old with a Charlson score of 0 compared with patients 80 years or older with a Charlson score of 1 or higher (48% vs 41%; P=.28). The VA site, number of positive FOBT cards, and number of VA outpatient visits were predictors. Of 122 patients who did not receive a complete follow-up within 1 year, 38% had documentation that comorbidity or preferences did not permit follow-up, and over the next 5 years 76% never received a complete follow-up.
conclusionsWhile follow-up after positive FOBT results was low regardless of age or comorbidity, screening patients in whom complete evaluation would not be pursued substantially contributes to lack of follow-up. Efforts to improve follow-up should address the full chain of decision making, including decisions to screen and decisions to follow up.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.