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BACKGROUND The rate of positive tests using fecal immunochemical test FIT does not decrease with subsequent campaigns but the positive predictive value of advanced neoplasia significantly decreases in subsequent campaign after a first negative test A relationship between the fecal hemoglobin concentration Fhb and the opportunity to detect a colorectal cancer in subsequent campaign has been shown AIM To predict the severity of colorectal lesions based on Fhb measured during previous colorectal cancer screening campaign METHODS This etiological study included 293750 patients aged 50-74 living in Auvergne-Rh ne-Alpes France These patients completed at least two FIT test -1 and test 0 between June 2015 and December 2019 Delay between test -1 and test 0 was 1 year and test -1 result was negative 150 ngHb mL The severity of colorectal lesions diagnosed at test 0 was described according to Fhb measured at test -1 Fhb -1 The relationship between the severity classified in seven ordinal categories and the predictive factors was analyzed in an ordered multivariate polytomous regression model RESULTS The test 0 positive rate was 4 0 and the colonoscopy completion rate was 97 1 in 11594 patients who showed a positive test 0 The colonoscopy detection rate was 77 7 in those 11254 patients who underwent a colonoscopy A total of 8748 colorectal lesions were detected including 2182 low-risk-polyps 2400 high-risk-polyp and 502 colorectal cancer The colonoscopy detection rate varied significantly with Fhb -1 0 ngHb mL 75 6 0-50 ngHb mL 77 3 50-100 ngHb mL 88 7 100-150 ngHb mL 90 3 P 0 001 People with a Fhb -1 within 100-150 ngHb mL P 0 001 were 2 6 2 2 3 0 times more likely to have a high severity level compared to those having a Fhb -1 value of zero This risk was reduced by 20 in patients aged 55-59 compared to those aged 55 adjusted odds ratio 0 8 0 6 1 0 CONCLUSION The study showed that higher Fhb -1 is correlated to an increased risk of severity of colorectal lesions This risk of severity increased among first-time participants age 55 and the elderly 70 To avoid the loss of chance in these age groups the FIT positivity threshold should be reduced to 100 ngHb mL The other alternative would be to reduce the time between the two tests in these age groups from the current 2 years to 1 year

Publication search with Colorectal lesion severity as keyword

Prediction of the severity of colorectal lesion by fecal hemoglobin concentration observed during previous test in the F...

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with Colorectal lesion severity as keyword