Clinical Utilization of Digital Rectal Examination and Fecal Occult Blood Testing Upon Hospital Admission

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Abstract
Goals The objective of our investigation was to examine the clinical utilization of digital rectal examination (DRE) and fecal occult blood testing (FOBT) at hospital admission. Background DRE at the time of hospital admission is frequently accompanied by FOBT. However, the utility of DRE with FOBT in this setting is unknown. Study The study cohort comprised consecutive admissions to an internal medicine service over a 3-month period. Patient characteristics were compared for subjects by DRE performance and FOBT result. Follow-up endoscopic procedures within 1 year of admission were recorded. Results Complete data were available for 806 of 832 patients (96.9%). Three hundred forty eight patients underwent DRE on admission (43.2%). Patients undergoing DRE/FOBT were older (mean age 60.4±18.4 y vs. 55.0±19.6 y, PP<0.001). Conclusions In this cohort, patients with a past history of GI disease or symptoms were more likely to undergo FOBT. Follow-up evaluation of positive FOBT in the absence of GI bleeding symptoms was very low. Low utilization and follow-up rates may limit the utility of admission DRE with FOBT for cancer screening.

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