Testing for fecal mystic blood can...

Testing for fecal mystic blood can reduce the incidence and mortality from colorectal cancer. An annual screening is commited for every person 50 years and older Eating r meat, domestic fowls fish, certain raw vegetables, or taking a certain medications can cause false-positive ordeal results. In addition, intake of vitamin C can cause false-negative touchstone results. Few data address the advisability of restricting the use of aspirin and nonsteroidal anti-inflammatory medicines (NSAIDs) during the stool specimen collection proces for fecal abstruse blood testing. Various studies have attempted to define this issue however have had different limitations. Clinical guidelines state that it is unclear if low-dose aspirin can cause false-positive touchstone results, and higher doses may cause question s Kahi and Imperiale evaluated whether the regular use of aspirin or NSAIDs has any result on the risk of false-positive fecal mysterious blood tests in patients that are likely to not away to family physicians.

The trial design was a prospective cohort meditation of patients referred to a Veterans Affairs medical center for evaluation of positive fecal mystical blood tests over 22 month All were scheduled for colonoscopy to chase up on the abnormal exhibition Before the procedure, patients were provided fecal invisible blood serial test cards to deduce three separate specimens, and the cards were courseed in a hospital laboratory. Patients who had significant risk for other gastrointestinal bleeding or were forward warfarin (Coumadin) or antiplatelet regimens were exclud from the study

After the colonoscopy was scheduled, patients were contacted by dint of phone and asked about the use of prescribed medications, medical conditions, their recall of the specimen collection instructions, and their use of over-the-counter NSAIDs. The definition of regular use of aspirin or NSAIDs was at least one time daily for at least three days by week at the time of the specimen collection. This was determined according to the interview process and by means of a medical record review. Patients had to have been taking aspirin or NSAIDs for at least single in kind month before the fecal unrevealed blood testing. Aspirin use was divided into three arranges 81 to 324 mg by means of day, 325 to 649 mg by means of day, and 650 to 1250 mg for day. The type of colorectal lesion that could explain a positive fecal unrevealed blood test was the primary result measure.

There were 193 participants (98 percent men) in the cogitation with a mean age of 66 years. In 79 percent of patients there were no colonoscopy findings that could account for the positive fecal veiled blood test results. Seventy percent of the participants were defined as regular users of aspirin or NSAIDs. Of these regular users, 21 percent had findings that explained the positive fecal mysterious blood test, compared with 19 percent of those who were not regular users. When analyzed, there was no association between the dose of aspirin and colonoscopic findings unlikely to explain the positive fecal mysterious blood test. There was no association between regular aspirin or NSAID use and false-positive fecal unknown blood test after multivariate analysis.

The authors end that aspirin and NSAID use does not increase the risk for false-positive fecal undetected blood tests. They add that their application of mind suggests that these two classes of medications do not ne to be restricted when patients are collecting stool samples for fecal mysterious blood tests.

KARL E MILLER, MD

Kahi CJ Imperiale TF Do aspirin and nonsteroidal anti-inflammatory mix with drugss cause false-positive fecal occult family test results? A prospective subject of attention in a cohort of veterans. Am J M December 1 2004;117:837-41

COPYRIGHT 2005 American Academy of Family Physicians

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