Positive FOBt tied to more than just colorectal neoplasms

  • He E & al.
  • Int J Epidemiol
  • 21 Jan 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Colorectal neoplasms and inflammatory bowel disease (IBD) are the 2 most common of 10 diagnoses associated with fecal occult blood testing (FOBt)-positivity in older women.
  • The risk of diagnoses other than colorectal neoplasms (colorectal cancer [CRC] and adenomas) and IBD is elevated about 2-fold.

Why this matters

  • First population-based study to calculate the risks of conditions in addition to CRC and colorectal adenoma associated with FOBt-positivity.

Study design

  • Population-based prospective cohort of 604,495 older women (age, 60-69 years) without CRC, screened with FOBt in the UK Bowel Cancer Screening Program and the Million Women Study.
  • FOBt results linked to national hospital admissions records 12-24 months later.
  • Funding: UK Medical Research; others.

Key results

  • FOBt-positivity (vs negativity) was associated with these diagnoses 12-24 months after screening:
    • CRC: adjusted risk ratio (aRR), 3.49 (95% CI, 2.31-5.26).
    • Colorectal adenoma: aRR, 4.88 (95% CI, 3.80-6.26).
    • Irritable bowel syndrome: aRR, 4.63 (95% CI, 2.79-7.69).
    • Diverticular disease: aRR, 2.20 (95% CI, 1.84-2.63).
    • Hemorrhoids: aRR, 2.29 (95% CI, 1.80-2.91).
    • Esophagitis: aRR, 1.36 (95% CI, 1.09-1.69).
    • Peptic ulcer: aRR, 1.54 (95% CI, 1.25-1.89).
    • Upper gastrointestinal cancer: insufficient data.
    • Anemia: aRR, 3.30 (95% CI, 2.60-4.18).
    • Potential bleeding tendency: aRR, 1.88 (95% CI, 1.66-2.13).

Limitations

  • Diagnoses predicated on hospital admission.
  • Observational design.

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