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Improving Followup of Positive Fecal Occult Blood Tests

18 Years
80 Years
Not Enrolling
Colorectal Cancer

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Trial Information

Improving Followup of Positive Fecal Occult Blood Tests

Screening programs using the fecal occult blood test (FOBT) have demonstrated a significant
reduction in colorectal cancer mortality, although only when accompanied by a complete
diagnostic evaluation of the colon in the setting of a positive result. 90% of patients
with a positive FOBT result have completed a subsequent colonoscopy within Harvard Vanguard
Medical Associates. This project will use a pre-post study design to increase the rate of
followup colonoscopy in the setting of positive FOBT results. Patients in the intervention
group will receive a personalized mailing highlighting their positive result and need for
colonoscopy, followed by telephone outreach from a centralized gastroenterology scheduling
office. The primary outcome will be the performance of colonoscopy, however we will also
perform chart reviews to identify predictors of completing appropriate followup.

Inclusion Criteria:

- Patients with positive fecal occult blood test during 2004, 2005, and 2006; and no
colonoscopy following this test result

Exclusion Criteria:

- Patients with active cardiopulmonary disease or limited life expectancy due to severe
illness such as malignancy

- Colonoscopy within 5 years prior to positive fecal occult blood test

- Age > 80 years

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Outcome Measure:

Performance of colonoscopy

Outcome Time Frame:

6 months

Principal Investigator

Thomas D Sequist, MD, MPH

Investigator Role:

Principal Investigator

Investigator Affiliation:

Harvard Vanguard Medical Associates


United States: Institutional Review Board

Study ID:

Sequist Colorectal Cancer



Start Date:

June 2007

Completion Date:

March 2008

Related Keywords:

  • Colorectal Cancer
  • Colorectal cancer
  • Fecal occult blood test
  • Abnormal test result
  • Missed diagnosis
  • Delayed diagnosis
  • Colorectal Neoplasms



Harvard Vanguard Medical AssociatesNewton, Massachusetts  02466