Document Detail


Prevalence of significant neoplasia in FOBT-positive patients on warfarin compared with those not on warfarin.
MedLine Citation:
PMID:  20683445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The fecal occult blood test (FOBT) is widely used for colorectal cancer screening. However, the impact of warfarin use on FOBT sensitivity and specificity remains unclear. This study compares the relative risk of neoplasia in FOBT-positive patients stratified by warfarin use.
METHODS: The Clinical Outcomes Research Initiative database was used to identify patients with positive FOBT as the only indication for colonoscopy during 2005-2006. Patients were categorized on the basis of documented warfarin status within a 30-day period before FOBT. We compared the demographics and prevalence of significant colon findings (defined as polyp >9 mm or suspected malignant tumor) among the two groups. After adjusting for confounding variables, logistic regression was used to estimate the odds ratio of significant findings in warfarin-positive vs. warfarin-negative patients.
RESULTS: Of 10,266 patients with positive FOBT, 372 used warfarin, 9,265 did not use warfarin, and 629 were excluded because of missing warfarin status. Warfarin-positive patients were more likely male (65 vs. 50%; P<0.0001), Caucasian (88 vs. 80%; P<0.0001), and veterans (53 vs. 33%; P<0.0001). The prevalence of a significant finding was greater in the warfarin group, 16 vs. 11.4% (P<0.01). After adjusting for age and sex, the relative risk of significant colon findings among warfarin-positive patients was not significantly different from warfarin-negative patients (odds ratio 1.1, 95% confidence interval: 0.81-1.44).
CONCLUSIONS: No increased risk for significant colonic findings among FOBT-positive patients according to warfarin use was identified. These findings suggest that continuing warfarin before FOBT will not affect the positive predictive value of this screening test.
Authors:
Lulu Iles-Shih; Judy F Collins; Jennifer L Holub; David A Lieberman
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Publication Detail:
Type:  Journal Article     Date:  2010-08-03
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-27     Revised Date:  2014-02-06    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2030-4; quiz 1962, 2035     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use
Colonoscopy
Colorectal Neoplasms / diagnosis,  epidemiology*
Databases, Factual
Female
Humans
Logistic Models
Male
Middle Aged
Occult Blood*
Odds Ratio
Predictive Value of Tests
Prevalence
Prospective Studies
Sensitivity and Specificity
Warfarin / therapeutic use*
Grant Support
ID/Acronym/Agency:
R33 DK061778/DK/NIDDK NIH HHS; U01 DK057132/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants; 5Q7ZVV76EI/Warfarin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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