Digital rectal fecal occult blood screening during gynecologic examination

The purpose of this study was to test the feasibility of digital rectal fecal occult blood screening during pelvic examination.

We reviewed the data for 232 consecutive women who underwent digital rectal fecal occult blood screening during routine pelvic examination and who had had at least 1-year of follow-up visits: 59% of the women were followed for gynecologic cancer, and 41% of the women were followed for benign gynecologic disease. The median age was 62 years. Patients with positive digital rectal fecal occult blood screening were sent for gastroenterologic examination.

Sixteen of 232 patients (7%) had a positive digital rectal fecal occult blood screening result. On gastroenterologic examination, 5 of the 16 patients (31%) were found to have disease (2 polyps, 1 diverticular disease, 2 radiation proctitis). At 1-year follow-up, no patient had colon cancer.

Until better compliance can be obtained with home stool sample fecal occult blood testing, we recommend a larger study of digital rectal fecal occult blood screening during gynecologic examination to verify our results.