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A Combination of Fecal Immunochemical Test Results and Iron Deficiency Anemia for Detection of Advanced Colorectal Neoplasia in Asymptomatic Men

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Purpose: A substantial proportion of patients with colorectal cancer (CRC) present with iron deficiency anemia (IDA), and fecal immunochemical test (FIT) has proven to be an effective method for detecting the majority of CRC cases. A combination strategy of FIT results and IDA may be useful for risk stratification for detecting advanced colorectal neoplasia (ACRN). We compared the prevalence of ACRN among four groups stratified by FIT results and the presence of IDA. Materials and Methods: A cross-sectional study was performed on asymptomatic male participants who underwent both FIT and colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea. Results: Of 17236 participants, 522 (3.0%) showed positive FIT results and 26 (0.2%) had IDA. The mean age of the study participantswas 40.8 years. The participants were classified into four groups: positive FIT result/IDA (G1, n=7), positive FIT result/no IDA (G2, n=515), negative FIT result/IDA (G3, n=19), and negative FIT result/no IDA (G4, n=16695). The prevalences of ACRN in G1, G2, G3, and G4 were 28.6, 13.4, 5.3, and 1.5%, respectively (p<0.001) and those of CRC were 28.6, 1.6, 0.0, and 0.01%, respectively(p<0.001). Subjects with positive FIT results and IDA had an increased risk of ACRN and CRC in both group aged <50 and ≥50 years. Conclusion: Subjects with positive FIT results and IDA had an increased risk of ACRN. Our results suggest that a combination strategy of FIT and IDA may be helpful in selecting and prioritizing asymptomatic men for colonoscopy.

Abstract

Purpose: A substantial proportion of patients with colorectal cancer (CRC) present with iron deficiency anemia (IDA), and fecal immunochemical test (FIT) has proven to be an effective method for detecting the majority of CRC cases. A combination strategy of FIT results and IDA may be useful for risk stratification for detecting advanced colorectal neoplasia (ACRN). We compared the prevalence of ACRN among four groups stratified by FIT results and the presence of IDA. Materials and Methods: A cross-sectional study was performed on asymptomatic male participants who underwent both FIT and colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea. Results: Of 17236 participants, 522 (3.0%) showed positive FIT results and 26 (0.2%) had IDA. The mean age of the study participantswas 40.8 years. The participants were classified into four groups: positive FIT result/IDA (G1, n=7), positive FIT result/no IDA (G2, n=515), negative FIT result/IDA (G3, n=19), and negative FIT result/no IDA (G4, n=16695). The prevalences of ACRN in G1, G2, G3, and G4 were 28.6, 13.4, 5.3, and 1.5%, respectively (p<0.001) and those of CRC were 28.6, 1.6, 0.0, and 0.01%, respectively(p<0.001). Subjects with positive FIT results and IDA had an increased risk of ACRN and CRC in both group aged <50 and ≥50 years. Conclusion: Subjects with positive FIT results and IDA had an increased risk of ACRN. Our results suggest that a combination strategy of FIT and IDA may be helpful in selecting and prioritizing asymptomatic men for colonoscopy.

참고문헌 (36)

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관련 논문AI추천

Risk of colorectal cancer in patients with positive results of fecal immunochemical test performed within 5 years since the last colonoscopy이진희, Chang Mo Moon, Yoon Suk Jung대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제5호Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea신현필, 이정일, 전정원, Dae Ho Kim, Jae Myung Cha, Jin Young Yoon, Kwang Ro Joo, Min Seob Kwak, Young-Hak Cho거트앤리버 소화기연관학회협의회 · Gut and Liver2018 · 제12권 제2호Positive fecal immunochemical test results are associated with non-colorectal cancer mortality문창모, 이진희, Yoon Suk Jung대한내과학회 · The Korean Journal of Internal Medicine2022 · 제37권 제2호Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?김남희, 박동일, 박정호, 손종일, 정윤숙, 최규용연세대학교의과대학 · Yonsei Medical Journal2017 · 제58권 제1호Risk and Characteristics of Postcolonoscopy Interval Colorectal Cancer after a Positive Fecal Test: A Nationwide Population-Based Study in Korea박동일, 서미나, 윤민주, 은창수, 이창균, 전재관, 최귀선, 한동수대한암학회 · Cancer Research and Treatment2018 · 제50권 제1호Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?Chong Il Sohn, Dong Il Park, Jung Ho Park, Kyuyong Choi, Nam Hee Kim, Yoon Suk Jung대한내과학회 · The Korean Journal of Internal Medicine2018 · 제33권 제6호

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