000095925 001__ 95925
000095925 005__ 20210902121617.0
000095925 0247_ $$2doi$$a10.3748/wjg.v26.i1.70
000095925 0248_ $$2sideral$$a116521
000095925 037__ $$aART-2020-116521
000095925 041__ $$aeng
000095925 100__ $$aPin-Vieito, N.
000095925 245__ $$aRetrospective cohort study: Risk of gastrointestinal cancer in a symptomatic cohort after a complete colonoscopy: Role of faecal immunochemical test
000095925 260__ $$c2020
000095925 5060_ $$aAccess copy available to the general public$$fUnrestricted
000095925 5203_ $$aBACKGROUND: Faecal immunochemical test (FIT) has been recommended to assess symptomatic patients for colorectal cancer (CRC) detection. Nevertheless, some conditions could theoretically favour blood originating in proximal areas of the gastrointestinal tract passing through the colon unmetabolized. A positive FIT result could be related to other gastrointestinal cancers (GIC).
AIM: To assess the risk of GIC detection and related death in FIT-positive symptomatic patients (threshold 10 µg Hb/g faeces) without CRC.
METHODS: Post hoc cohort analysis performed within two prospective diagnostic test studies evaluating the diagnostic accuracy of different FIT analytical systems for CRC and significant colonic lesion detection. Ambulatory patients with gastrointestinal symptoms referred consecutively for colonoscopy from primary and secondary healthcare, underwent a quantitative FIT before undergoing a complete colonoscopy. Patients without CRC were divided into two groups (positive and negative FIT) using the threshold of 10 µg Hb/g of faeces and data from follow-up were retrieved from electronic medical records of the public hospitals involved in the research. We determined the cumulative risk of GIC, CRC and upper GIC. Hazard rate (HR) was calculated adjusted by age, sex and presence of significant colonic lesion.
RESULTS: We included 2709 patients without CRC and a complete baseline colonoscopy, 730 (26.9%) with FIT = 10 µgr Hb/gr. During a mean time of 45.5 ± 20.0 mo, a GIC was detected in 57 (2.1%) patients: An upper GIC in 35 (1.3%) and a CRC in 14 (0.5%). Thirty-six patients (1.3%) died due to GIC: 22 (0.8%) due to an upper GIC and 9 (0.3%) due to CRC. FIT-positive subjects showed a higher CRC risk (HR 3.8, 95%CI: 1.2-11.9) with no differences in GIC (HR 1.5, 95%CI: 0.8-2.7) or upper GIC risk (HR 1.0, 95%CI: 0.5-2.2). Patients with a positive FIT had only an increased risk of CRC-related death (HR 10.8, 95%CI: 2.1-57.1) and GIC-related death (HR 2.2, 95%CI: 1.1-4.3), with no differences in upper GIC-related death (HR 1.4, 95%CI: 0.6-3.3). An upper GIC was detected in 22 (0.8%) patients during the first year. Two variables were independently associated: anaemia (OR 5.6, 95%CI: 2.2-13.9) and age = 70 years (OR 2.7, 95%CI: 1.1-7.0).
CONCLUSION: Symptomatic patients without CRC have a moderate risk increase in upper GIC, regardless of the FIT result. Patients with a positive FIT have an increased risk of post-colonoscopy CRC.
000095925 536__ $$9info:eu-repo/grantAgreement/EUR/ERDF-ESF/Investing in your future$$9info:eu-repo/grantAgreement/EUR/ISCII-ERDF/A way to make Europe$$9info:eu-repo/grantAgreement/ES/ISCIII-ERDF-FSE/PI17-00837
000095925 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttp://creativecommons.org/licenses/by-nc/3.0/es/
000095925 590__ $$a5.742$$b2020
000095925 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b28 / 92 = 0.304$$c2020$$dQ2$$eT1
000095925 592__ $$a1.427$$b2020
000095925 593__ $$aMedicine (miscellaneous)$$c2020$$dQ1
000095925 593__ $$aGastroenterology$$c2020$$dQ1
000095925 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000095925 700__ $$aIglesias, M. J.
000095925 700__ $$aRemedios, D.
000095925 700__ $$aRodríguez-Alonso, L.
000095925 700__ $$aRodriguez-Moranta, F.
000095925 700__ $$aÁlvarez-Sánchez, V.
000095925 700__ $$aFernández-Bañares, F.
000095925 700__ $$aBoadas, J.
000095925 700__ $$aMartínez-Bauer, E.
000095925 700__ $$aCampo, R.
000095925 700__ $$aBujanda, L.
000095925 700__ $$0(orcid)0000-0003-2280-9372$$aFerrandez, Á.$$uUniversidad de Zaragoza
000095925 700__ $$aPiñol, V.
000095925 700__ $$aRodríguez-Alcalde, D.
000095925 700__ $$aGuardiola, J.
000095925 700__ $$aCubiella, J.
000095925 700__ $$aGonzález-López, N.
000095925 700__ $$aQuintero, E.
000095925 700__ $$aBañales, J.
000095925 700__ $$aBujanda, L.
000095925 700__ $$aPerugorria, M. J.
000095925 700__ $$aCleries, R.
000095925 700__ $$aRibes, J.
000095925 700__ $$aSanz, X.
000095925 700__ $$aLópez-Vicente, J.
000095925 700__ $$aRodriguez-Alcalde, D.
000095925 700__ $$aPiñol, V.
000095925 700__ $$aTorrealba, L.
000095925 700__ $$aBlanco, I.
000095925 700__ $$aCubiella, J.
000095925 700__ $$aDíaz-Ondina, M.
000095925 700__ $$aSalve, M.
000095925 700__ $$aFernández-Seara, J.
000095925 700__ $$aIglesias, M. J.
000095925 700__ $$aMacía, P.
000095925 700__ $$aRemedios, D.
000095925 700__ $$aSánchez, E.
000095925 700__ $$aVega, P.
000095925 700__ $$aCampo, R.
000095925 700__ $$aMartínez-Bauer, E.
000095925 700__ $$aPujol, M.
000095925 700__ $$aSánchez, V. Á.
000095925 700__ $$aMera, J.
000095925 700__ $$aTurnes, J.
000095925 700__ $$aClofent, J.
000095925 700__ $$aGarayoa, A.
000095925 700__ $$aFernández-Bañares, F.
000095925 700__ $$aGonzalo, V.
000095925 700__ $$aPujals, M.
000095925 700__ $$aBoadas, J.
000095925 700__ $$aGalter, S.
000095925 700__ $$aGarcia-Lanuza, E.
000095925 700__ $$aGimeno, R.
000095925 700__ $$aAlsius, A.
000095925 700__ $$aFerrández, Á.
000095925 700__ $$aSánchez, M. S.
000095925 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000095925 773__ $$g26, 1 (2020), 70-85$$tWorld Journal of Gastroenterology$$x1007-9327
000095925 8564_ $$s713236$$uhttps://zaguan.unizar.es/record/95925/files/texto_completo.pdf$$yVersión publicada
000095925 8564_ $$s138144$$uhttps://zaguan.unizar.es/record/95925/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000095925 909CO $$ooai:zaguan.unizar.es:95925$$particulos$$pdriver
000095925 951__ $$a2021-09-02-08:45:07
000095925 980__ $$aARTICLE