Evaluating follow-up of positive fecal occult blood test results: lessons learned

The objective of this study was to assess the effectiveness of a follow-up system for positive fecal occult blood test (FOBT) results in a single tertiary care hospital. The system consisted of a designated nurse who reviewed records of all positive FOBT cases for appropriate follow-up testing and notified clinic managers if no follow-up occurred. This system identified 63/423 (15%) of positive FOBT cases with inadequate follow-up in a 10-month period, but it was unsuccessful in ensuring subsequent follow-up in 24% of these cases. Primary care providers often lacked knowledge regarding appropriate follow-up testing. More direct follow-up of positive FOBT results is recommended.