Kim Nam Hee, Lee Mi Yeon, Park Jung Ho, Park Dong Il, Sohn Chong Il, Choi Kyuyong, Jung Yoon Suk
Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Seoul, Korea.
Yonsei Med J. 2017 Sep;58(5):910-917. doi: 10.3349/ymj.2017.58.5.910.
A substantial proportion of patients with colorectal cancer (CRC) present with iron deficiency anemia (IDA), and fecal immunochemical test (FIT) has proven to be an effective method for detecting the majority of CRC cases. A combination strategy of FIT results and IDA may be useful for risk stratification for detecting advanced colorectal neoplasia (ACRN). We compared the prevalence of ACRN among four groups stratified by FIT results and the presence of IDA.
A cross-sectional study was performed on asymptomatic male participants who underwent both FIT and colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea.
Of 17236 participants, 522 (3.0%) showed positive FIT results and 26 (0.2%) had IDA. The mean age of the study participants was 40.8 years. The participants were classified into four groups: positive FIT result/IDA (G1, n=7), positive FIT result/no IDA (G2, n=515), negative FIT result/IDA (G3, n=19), and negative FIT result/no IDA (G4, n=16695). The prevalences of ACRN in G1, G2, G3, and G4 were 28.6, 13.4, 5.3, and 1.5%, respectively (p<0.001) and those of CRC were 28.6, 1.6, 0.0, and 0.01%, respectively (p<0.001). Subjects with positive FIT results and IDA had an increased risk of ACRN and CRC in both group aged <50 and ≥50 years.
Subjects with positive FIT results and IDA had an increased risk of ACRN. Our results suggest that a combination strategy of FIT and IDA may be helpful in selecting and prioritizing asymptomatic men for colonoscopy.
相当一部分结直肠癌（CRC）患者表现为缺铁性贫血（IDA），粪便免疫化学试验（FIT）已被证明是检测大多数CRC病例的有效方法。FIT结果与IDA的联合策略可能有助于对晚期结直肠肿瘤（ACRN）进行风险分层。我们比较了根据FIT结果和IDA情况分层的四组患者中ACRN的患病率。
对2010年至2014年间作为韩国一项综合健康筛查项目一部分同时接受FIT和结肠镜检查的无症状男性参与者进行了一项横断面研究。
在17236名参与者中，522人（3.0%）FIT结果为阳性，26人（0.2%）患有IDA。研究参与者的平均年龄为40.8岁。参与者被分为四组：FIT结果阳性/IDA（G1组，n = 7）、FIT结果阳性/无IDA（G2组，n = 515）、FIT结果阴性/IDA（G3组，n = 19）和FIT结果阴性/无IDA（G4组，n = 16695）。G1、G2、G3和G4组中ACRN的患病率分别为28.6%、13.
