Foregut malignancy after discordant fecal immunochemical test: A cohort study at a United States safety-net hospital

Figure 1 Cohort derivation flow diagram. Of 1610 records screened, 379 fecal immunochemical test (FIT)-positive patients met inclusion criteria and were classified as discordant (n = 172) or concordant (n = 207) based on colonoscopy findings. The most common reason for exclusion was absence of a confirmed positive FIT on chart review (n = 1152). Discordant patients included those with no explanatory finding or hemorrhoids with additional non-concordant findings (n = 115) and those with hemorrhoids only (n = 57), classified as discordant based on meta-analytic evidence that hemorrhoids do not significantly contribute to false-positive FIT results. Among concordant patients, colorectal neoplasia accounted for 183 (88.4%) and an alternative explanatory lesion for 24 (11.6%). FIT+: Fecal immunochemical test-positive; FOBT: Fecal occult blood test; EGD: Esophagogastroduodenoscopy; GI: Gastrointestinal; IBD: Inflammatory bowel disease; aOR: Adjusted odds ratio.