000079009 001__ 79009
000079009 005__ 20230914083232.0
000079009 0247_ $$2doi$$a10.3389/fmed.2019.00091
000079009 0248_ $$2sideral$$a111492
000079009 037__ $$aART-2019-111492
000079009 041__ $$aeng
000079009 100__ $$aNavarro, M.
000079009 245__ $$aFaecal haemoglobin concentration, a good predictor of risk of advanced colorectal neoplasia in symptomatic and asymptomatic patients
000079009 260__ $$c2019
000079009 5060_ $$aAccess copy available to the general public$$fUnrestricted
000079009 5203_ $$aBackground: Periodical faecal immunochemical testing (FIT) is a cost-effective strategy in colon cancer screening programmes. FIT is also used as a diagnostic test in symptomatic patients. but data are scarce.
Aim: To determine the association between FIT-Hb concentration and the risk of advanced neoplasia (AN) detected in colonoscopy in two different populations. Methods. The outcomes of colonoscopies performed after a positive FIT (> 117 ng/ml) (Sentinel Gold test) result were analysed in patients included within a population-based CRC screening programme (screening group) and, as diagnostic evaluation in symptomatic patients (symptomatic group). The study was performed between January 1st, 2014 and October 31, 2016. Data are reported Con as medians with interquartile ranges or frequencies and percentages. Positive predictive value (PPV) at arbitrary faecal haemoglobin concentrations were also reported calculated for AN.
Results: We recruited 2742 patients who underwent a colonoscopy procedure, 1515 (53.5%) of them within the CRC screening programme. Patients in the screening group were younger (65.0±3.3 vs 66.2±13.4 years, p < 0.001) and more frequently male (p < 0.001) vs. the symptomatic group. Colonoscopy found more frequently neoplastic lesions in the screening compared to the symptomatic group (61.9% vs 44.8% p < 0.001). Hb concentration in FIT was significantly higher in patients with AN compared with patients without AN in both groups (p < 0.001). The age-adjusted risk of AN increased significantly in both groups according to FIT Hb concentration in the Quartile 3 (OR (95% CI): 2.94 (2.33-3.71) and Quartile 4 (OR: 5.52 (4.36-6.99). Males, in both groups showed a higher probability of presenting AN. FIT values were higher for left- than for right-sided AN in the screening, but not in the symptomatic group. Positive predictive values for AN were higher in the screening group in positive FIT tests (range 43.9% - 70.5%; 117 to > 1000 ng/ml) compared to those in the symptomatic group (36.3% - 52.5%). Similar trends were observed for cancer diagnosis alone.
Conclusions: Male gender, age and FIT Hb concentration are predictors of risk of advanced adenoma and colorectal cancer and should be used to prioritise colonoscopy in patients with suspected advanced neoplasia, both in screening and in symptomatic patients.
000079009 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000079009 590__ $$a3.9$$b2019
000079009 591__ $$aMEDICINE, GENERAL & INTERNAL$$b29 / 165 = 0.176$$c2019$$dQ1$$eT1
000079009 592__ $$a1.18$$b2019
000079009 593__ $$aMedicine (miscellaneous)$$c2019$$dQ1
000079009 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000079009 700__ $$aHijos, G.
000079009 700__ $$aRamirez, T.
000079009 700__ $$aOmella, I.
000079009 700__ $$aFuentes, P.C.L.
000079009 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, A.$$uUniversidad de Zaragoza
000079009 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000079009 773__ $$g6, APR (2019), 91$$pFront. med.$$tFrontiers in Medicine$$x2296-858X
000079009 8564_ $$s260966$$uhttps://zaguan.unizar.es/record/79009/files/texto_completo.pdf$$yVersión publicada
000079009 8564_ $$s50839$$uhttps://zaguan.unizar.es/record/79009/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000079009 909CO $$ooai:zaguan.unizar.es:79009$$particulos$$pdriver
000079009 951__ $$a2023-09-13-10:44:54
000079009 980__ $$aARTICLE