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Checking for Fecal Occult Blood With Digital Rectal Examinations-Reply

James H. Lewis, MD
Arch Intern Med. 1992;152(9):1929. doi:10.1001/archinte.1992.00400210147030.
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In Reply.—  We thank Chelmowski for his comments. In response to his question regarding the number of individuals who were asymptomatic at the time of fecal occult blood testing (FOBT) in our retrospective study1 (the majority of whom were outpatients referred for colonoscopy after FOBT results were obtained by the spontaneous passage of stool method), we explain that most were, in fact, asymptomatic. Very few of the inpatients (representing approximately half of all patients) were asymptomatic. In addition, only one of the 24 individuals in whom colorectal carcinoma was detected was entirely asymptomatic and this individual was an outpatient in whom the stool was spontaneously passed.We agree that prospectively controlled studies in asymptomatic individuals will be necessary to more fully understand the meaning of a positive FOBT result obtained by either method. However, until such data become available, we stand by our conclusion that any positive FOBT result


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