A clinical research study from the Indiana University School of Medicine and the Regenstrief Institute examines the use of FIT (fecal immunochemical tests), which look for blood, a possible sign of colon cancer, in stool, in emergency situations and in the inpatient setting. The researchers conclude that FIT should only be used for its validated colon cancer screening indication and not for the assessment of gastrointestinal bleeding, abdominal pain, or iron deficiency anemia and other symptoms or problems that bring people to the hospital.
“FIT is a cancer screening tool, not a test for symptoms, such as symptoms such as rectal bleeding, abdominal pain, or a change in bowel habits,” said study co-author Thomas F. Imperiale, MD, of the Regenstrief Institute and IU School of Medicine. “Getting a FIT from an ED [emergency department] a patient or an inpatient would order a mammogram or pap smear for a woman in hospital for pneumonia, heart failure, or cellulitis. It’s just not appropriate in that setting. You don’t do FIT in the hospital or inpatient setting, where clinicians need to focus on active clinical issues and their outcomes instead of focusing on screening. “
History, physical exam, and diagnostic tests are critical to hospital care, but FIT plays a role, according to Dr. Imperials do not play a role in diagnosing these patients. In addition, he notes, there is a potential for false-positive risk and higher false-negative risk (that is, something of clinical importance to be overlooked) in patients with symptoms.
A review of the electronic medical record (EMR) by the study authors found that from November 2017 to October 2019, 203,667 patients were either screened in the emergency room or hospitalized with only 550 FITs identified. While these results suggest that only a very small number of emergency or inpatient FIT tests were performed, 99 percent of the time the test was inappropriately performed.
According to Dr. More work is needed at Imperiale to determine how often and in which hospitals – rural, municipal, inner-city or other – FIT is used in emergencies and in the inpatient setting. He notes that the use of FIT in an emergency or in the inpatient area not only does not improve health care, but can also lead to unnecessary follow-up costs.
The study will be online in the American Journal of Medicine.
Study highlights urgent need for improved access to emergency care
Umer Bhatti et al., Not FIT for Use: Immunochemical Testing in the station and Emergency Settings, The American Journal of Medicine (2021). DOI: 10.1016 / j.amjmed.2021.08.004
Provided by the Regenstrief Institute
Quote: No FIT: Colon cancer screening FIT does not belong in emergency and inpatient facilities (2021, November 15), accessed on November 15, 2021 from https://medicalxpress.com/news/2021-11-colon-cancer-screening -doesnt- emergency.html
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