Risk of gastrointestinal cancer in a symptomatic cohort after a complete colonoscopy:Role of faecal immunochemical test

作     者：Noel Pin-Vieito María J Iglesias David Remedios Lorena Rodríguez-Alonso Francisco Rodriguez-Moranta VictoriaÁlvarez-Sánchez Fernando Fernández-Bañares Jaume Boadas Eva Martínez-Bauer Rafael Campo Luis Bujanda Ángel Ferrandez Virginia Piñol Daniel Rodríguez-Alcalde Jordi Guardiola Joaquín Cubiella 

作者机构：Gastroenterology DepartmentComplexo Hospitalario Universitario de OurenseCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas(CIBERehd)Ourense 32005Spain Department of Gastroenterology and HepatologyUniversity Hospital of Bellvitge-IDIBELLL'Hospitalet de LlobregatBarcelona 08907Spain.Ciber de Epidemiología y Salud Pública(CIBERESP)Spain Gastroenterology DepartmentComplejo Hospitalario de PontevedraPontevedra 36001Spain Gastroenterology DepartmentHospital Universitari Mútua de TerrassaCIBERehdTerrassa 08221Spain Gastroenterology DepartmentConsorci Sanitari de TerrassaTerrassa 08221Spain Gastroenterology DepartmentHospital de SabadellCorporacióSanitària Donostia HospitalBiodonostia InstituteUniversity of the Basque Country UPV/EHUCIBERehdSan Sebastian 20010Spain Servicio de Aparato DigestivoHospital Clínico UniversitarioIIS AragónUniversity of ZaragozaCIBERehdZaragoza 50009Spain Gastroenterology DepartmentHospital Dr.Josep TruetaGirona 17007Spain Digestive Disease SectionHospital Universitario de MóstolesMadrid 28935Spain 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第1期

页      面：70-85页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by Instituto de Salud Carlos III through the project PI17/00837(Co-funded by European Regional Development Fund/European Social Fund"A way to make Europe"/"Investing in your future") 

主　　题：Colonoscopy Colorectal cancer Faecal immunochemical test Gastric cancer Gastroesophageal cancer Gastrointestinal cancer Symptoms 

摘      要：BACKGROUND Faecal immunochemical test(FIT)has been recommended to assess symptomatic patients for colorectal cancer(CRC)***,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 10μg Hb/g faeces)without *** 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 *** patients with gastrointestinal symptoms referred consecutively for colonoscopy from primary and secondary healthcare,underwent a quantitative FIT before undergoing a complete *** without CRC were divided into two groups(positive and negative FIT)using the threshold of 10μg Hb/g of faeces and data from follow-up were retrieved from electronic medical records of the public hospitals involved in the *** determined the cumulative risk of GIC,CRC and upper *** rate(HR)was calculated adjusted by age,sex and presence of significant colonic *** We included 2709 patients without CRC and a complete baseline colonoscopy,730(26.9%)with FIT≥10μgr Hb/*** 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 ***-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