Gastroscopy following a positive fecal occult blood test and negative colonoscopy: systematic review and guideline.

Published

Journal Article (Review)

BACKGROUND:A sizeable number of individuals who participate in population-based colorectal cancer (CRC) screening programs and have a positive fecal occult blood test (FOBT) do not have an identifiable lesion found at colonoscopy to account for their positive FOBT screen. OBJECTIVE:To evaluate the evidence and provide recommendations regarding the use of routine esophagogastroduodenoscopy (EGD) to detect upper gastrointestinal (UGI) cancers in patients participating in a population-based CRC screening program who are FOBT positive and colonoscopy negative. METHODS:A systematic review was used to develop the evidentiary base and to inform the evidence-based recommendations provided. RESULTS:Nine studies identified a group of patients who were FOBT positive and colonoscopy negative. Three studies found no cases of UGI cancer. Four studies reported cases of UGI cancer; three found UGI cancer in 1% or less of the population studied, and one study found one case of UGI cancer that represented 7% of their small subgroup of FOBT-positive/colonoscopy-negative patients. Two studies did not provide outcome information that could be specifically related to the FOBT-positive/colonoscopy-negative subgroup. CONCLUSION:The current body of evidence is insufficient to recommend for or against routine EGD as a means of detecting gastric or esophageal cancers for patients who are FOBT positive/colonoscopy negative, in a population-based CRC screening program. The decision to perform EGD should be individualized and based on clinical judgement.

Full Text

Cited Authors

  • Allard, J; Cosby, R; Del Giudice, ME; Irvine, EJ; Morgan, D; Tinmouth, J

Published Date

  • February 2010

Published In

Volume / Issue

  • 24 / 2

Start / End Page

  • 113 - 120

PubMed ID

  • 20151070

Pubmed Central ID

  • 20151070

Electronic International Standard Serial Number (EISSN)

  • 1916-7237

International Standard Serial Number (ISSN)

  • 0835-7900

Digital Object Identifier (DOI)

  • 10.1155/2010/516363

Language

  • eng