Endoscopy 2018; 50(04): S94-S95
DOI: 10.1055/s-0038-1637309
ESGE Days 2018 oral presentations
21.04.2018 – Colon: CRC screening
Georg Thieme Verlag KG Stuttgart · New York

PREDICTIVE FACTORS OF FALSE-POSITIVE FECAL IMMUNOCHEMICAL TEST RESULTS

C Mangas
1   Hospital General Universitario de Alicante, Alicante, Spain
,
E Santana
1   Hospital General Universitario de Alicante, Alicante, Spain
,
J Cubiella
2   Complexo Hospitalario Universitario de Ourense, Ourense, Spain
,
A Suárez
3   Hospital Universitario Central de Asturias, Oviedo, Spain
,
I Portillo
4   Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco, San Sebastián, Spain
,
A Seoane
5   Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
,
M Ponce
6   Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
P Díez
7   Hospital Universitario Río Hortega, Valladolid, Spain
,
E Quintero
8   Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
,
M Herráiz
9   Clínica Universitaria de Navarra, Pamplona, Spain
,
M Pellisé
10   Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
,
Á Ferrández
11   Hospital Clínico Lozano Blesa, Universidad de Zaragoza, Zaragoza, Spain
,
V Hernández
12   Grupo de Investigación en Patología Digestiva, Vigo, Spain
,
Á Pizarro
13   Hospital Universitario Virgen del Rocío, Sevilla, Spain
,
R Jover
1   Hospital General Universitario de Alicante, Alicante, Spain
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Publikationsverlauf

Publikationsdatum:
27. März 2018 (online)

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Aims:

Colorectal cancer (CRC) screening aims the reduction of the incidence and mortality of CRC, and fecal immunochemical test (FIT) is one of the main screenings methods. Since it was introduced, the number of colonoscopies has increased, so the burden of procedures as well. False-positive FIT results (FP-FIT) increase the unnecessary procedures and there is scarce evidence about the FP-FIT rate in Spain. So the aim of this study was to evaluate the FP-FIT rate and the factors related to it.

Methods:

Observational, multicenter and cross-sectional study. Inclusion criteria: patients aged 40 – 80yo and FIT+. FP-FIT result has been considered when neither advanced adenomas nor CRC have been detected. FIT threshold is ≥100 µg/g, and after a FIT+ result, patients undergo a colonoscopy.

Results:

3463 colonoscopies FIT+ were included. 56.1% (1942) were men, the median age was 61yo (P2556-P7566) and the median BMI 27 Kg (P2524- P7530). 14.3% (317) had diabetes and 1.5% (33) chronic kidney injury (CKI). The rate of adequate colon cleansing was 91.7% (3115), the cecal intubation rate 96.8% (3339) and the rate of sedation 92.1% (3169). 12.4% (266) used antiplatelets agents, 4.7% (101) anticoagulants and 0.7% (14) new oral anticoagulants (NOAC). 1.4% (47) had angiodysplasia, 10.8% (374) colonic diverticula and 5.5% (186) hemorrhoids. The advanced adenoma detection rate was 32% (611), the CRC detection rate 4.5% (53) and FP-FIT rate was 63.2% (1238).

A univariate and multivariate statistical analysis were performed. In the multivariate analysis, sex (women) was associated with FP-FIT (p < 0.001, aOR2.5, 95% CI 2.0 – 3.2). In addition, the usage of antiplatelet agents (p = 0.011, aOR1.6, 95% CI 1.1 – 2.2), the presence of colonic diverticula (p = 0.011, aOR1.4, 95% CI 1.1 – 2.0) and hemorrhoids (p = 0.001, aOR1.9, 95% CI 1.3 – 2.7) were associated with higher risk of FP-FIT. No statistical differences between the age, BMI, use of anticoagulants, NOAC, angiodysplasia, CKI or diabetes were found.

Conclusions:

Women, usage of antiplatelet agents, colonic diverticula and the presence of hemorrhoids are independent factors related to an increase false-positive FIT rate.