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Faecal haemoglobin concentration is related to severity of colorectal neoplasia

Authors :
Francis A. Carey
Jayne Digby
Robert H. Diament
Callum G. Fraser
Judith A. Strachan
Robert Steele
Margaret Balsitis
Paula J. McDonald
Source :
Journal of Clinical Pathology. 66:415-419
Publication Year :
2013
Publisher :
BMJ, 2013.

Abstract

AimsGuaiac faecal occult blood tests are being replaced by faecal immunochemical tests (FIT). We investigated whether faecal haemoglobin concentration (f-Hb) was related to stage in progression of colorectal neoplasia, studying cancer and adenoma characteristics in an evaluation of quantitative FIT as a first-line screening test.MethodsWe invited 66 225 individuals aged 50–74 years to provide one sample of faeces. f-Hb was measured on samples from 38 720 responders. Colonoscopy findings and pathology data were collected on the 943 with f-Hb≥400 ng Hb/ml (80 µg Hb/g faeces).ResultsOf the 814 participants with outcome data (median age: 63 years, range 50–75, 56.4% male), 39 had cancer, 190 high-risk adenoma (HRA, defined as ≥3 or any ≥10 mm) and 119 low-risk adenoma (LRA). 74.4% of those with cancer had f-Hb>1000 ng Hb/ml compared with 58.4% with HRA, and 44.1% with no pathology. Median f-Hb concentration was higher in those with cancer than those with no (p10 mm) compared with small adenoma (pConclusionsf-Hb is related to severity of colorectal neoplastic disease. This has ramifications for the selection of the appropriate cut-off concentration adopted for bowel screening programmes.

Details

ISSN :
14724146 and 00219746
Volume :
66
Database :
OpenAIRE
Journal :
Journal of Clinical Pathology
Accession number :
edsair.doi.dedup.....b5788a666ee55a640acd3acdd65e24b7
Full Text :
https://doi.org/10.1136/jclinpath-2013-201445