Time from positive screening fecal occult blood test to colonoscopy and risk of neoplasia

Dig Dis Sci. 2009 Nov;54(11):2497-502. doi: 10.1007/s10620-008-0653-8. Epub 2008 Dec 18.


There is no guideline defining the optimal time from a positive screening fecal occult blood test to follow-up colonoscopy. We reviewed records of 231 consecutive primary care patients who received a colonoscopy within 18 months of a positive fecal occult blood test. We examined the relationship between time to colonoscopy and risk of neoplasia on colonoscopy using a logistic regression analysis adjusting for potential confounders such as age, race, and gender. The mean time to colonoscopy was 236 days. Longer time to colonoscopy (OR = 1.10, P = 0.01) and older age (OR 1.04, P = 0.01) were associated with higher odds of neoplasia. The association of time with advanced neoplasia was positive, but not statistically significant (OR 1.07, P = 0.14). In this study, a longer interval to colonoscopy after fecal occult blood test was associated with an increased risk of neoplasia. Determining the optimal interval for follow-up is desirable and will require larger studies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Colonic Neoplasms / diagnosis*
  • Colonoscopy*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Occult Blood*
  • Retrospective Studies
  • Risk Factors
  • Time Factors