The compliance rate for the second diagnostic evaluation after a positive fecal occult blood test: A systematic review and meta-analysis:

IntroductionOnly a minority of patients with a positive fecal occult blood test (FOBT) undergo a follow-up second diagnostic procedure, thus minimizing its contribution for colorectal cancer (CRC) prevention. We aimed to obtain a precise estimation of this problem and also assess the diagnostic yield of CRC and adenomas by colonoscopy in these patients.MethodsLiterature searches were conducted for “compliance” OR “adherence” AND “fecal occult blood test” OR “fecal immunohistochemical test” AND “colonoscopy.” Comprehensive meta-analysis software was used.ResultsThe search resulted in 42 studies (512,496 patients with positive FOBT), published through December 31, 2017. A funnel plot demonstrates a moderate publication bias. Compliance with any second procedure, colonoscopy, or combination of double-contrast barium enema with or without sigmoidoscopy in patients with a positive FOBT was 0.725 with 95% confidence interval (CI) 0.649–0.790 (p = 0.000), 0.804 with 95% CI 0.740–0.856 (p = 0.000) and 0.197 with ...