Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?
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Purpose: False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening couldlead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topicare extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods: A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regressionanalysis was performed to determine factors associated with FP FIT results. Results: Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participantswith positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participantswith hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants withhemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally,the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing nosuch abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identifiedas an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion: Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributorof FP results in FIT-based CRC screening programs.
Abstract
Purpose: False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening couldlead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topicare extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods: A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regressionanalysis was performed to determine factors associated with FP FIT results. Results: Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participantswith positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participantswith hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants withhemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally,the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing nosuch abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identifiedas an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion: Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributorof FP results in FIT-based CRC screening programs.
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