North Texas GME Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

Document Type


Publication Date



colorectal cancer, stool tests, health screenings


Digestive System Diseases | Internal Medicine | Medicine and Health Sciences | Neoplasms


BACKGROUND: With the rising incidence and mortality of colorectal cancer (CRC), early diagnosis and treatment is imperative. At-home CRC screening kits are a non-invasive Federal Drug Association (FDA) approved designed to detects either hemoglobin or DNA markers associated for CRC and high-grade polyps. Therefore, therapies that have a propensity to increase rates of gastrointestinal bleeding could theoretically lead to higher false positive rates. The goal of this study was to determine the positive predictive value of at-home screening tests when applied to patients on therapies such as antiplatelet, anticoagulant, non-steroidal anti-inflammatory (NSAID), or a combination of the three. METHODS: The health system’s enterprise data warehouse was used to retrospectively review patients (>18 years old) who had a colonoscopy and documented in medical notes or lab results as a positive or abnormal at-home CRC screening test. Patients were categorized into five groups: anticoagulant only use, NSAID only use, antiplatelet only use, any combination of the three, or no use of any. Fisher’s Exact Test evaluated the association in rates of diagnosis of colorectal cancer among groups with the different medication use. RESULTS: A total of 1,366 patients were included in this study. Of the 1,366 patients, 62 (4.5%) had anticoagulant only, 114 (8.3%) NSAIDs only, 275 (20.1%) antiplatelet only, 82 (6.0%) combination, and 833 (61.0%) no medications. The results of the study indicated that there was no statistical significance between medication type and rate of positive diagnosis of CRC (p=0.8184). Pairwise comparison tests also did not reveal significant differences of positive diagnosis of CRC between patients using anticoagulant (p=1.0000), NSAIDs (p=0.4683), antiplatelet (p=0.5851), or combination (p=1.0000). CONCLUSION: While no statistical significance was found between pharmacologic therapy groups and rates of positive diagnosis of CRC, the results of this study suggest that these medications do not need to be discontinued prior to conducting an at-home screening test. Further research is necessary to continue to evaluate the impact of polypharmacy combinations and predictive results on non-invasive CRC screening.

Original Publisher

HCA Healthcare Graduate Medical Education


1st Place - Research Category

Comparing the PPV of At-Home Screening Tests with chronic anticoagulant and/or antiplatelet therapies



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