Incidence of colorectal neoplasia increased in those with higher baseline immunochemical test
Thursday, May 19, 2011 (Last Updated: 05/23/2011)
THURSDAY, May 19 (HealthDay News) -- Patients screened for colorectal cancer via immunochemical fecal occult blood test (iFOBT) can be stratified for cancer risk by degree of baseline fecal hemoglobin concentration, according to research published online May 17 in The Lancet Oncology.
Li-Sheng Chen, Ph.D., of the Taipei Medical University in Taiwan, and colleagues followed 45,992 subjects, 1,668 of whom had a positive result at first iFOBT screening (using a cutoff value of 100 ng/mL), to identify subsequent cases of colorectal neoplasia and investigate the association between baseline fecal hemoglobin concentration and risk for neoplasia.
During the median 4.39 years of follow-up, the incidence of colorectal neoplasia increased with baseline fecal hemoglobin concentration, from 1.74 per 1,000 person-years in those whose baseline concentration was 1 to 19 ng/mL, to 7.08 per 1,000 person-years in those whose baseline concentration was 80 to 99 ng/mL. The researchers concluded that risk stratification based on fecal hemoglobin could be helpful for clinicians, with attention being paid to those with higher initial hemoglobin concentrations in particular.
"Since, to our knowledge, this is the first study to use initial fecal hemoglobin concentration as a predictor of incident colorectal neoplasia, the methods and results should be validated to ensure they are reproducible in other countries," the authors write. "However, our study suggests that baseline fecal hemoglobin concentrations below the normal limit at which a patient is referred for colonoscopy can be informative when planning subsequent triage (panel)."
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