Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
Korean J Intern Med. 2022 Mar;37(2):313-321. doi: 10.3904/kjim.2021.081. Epub 2021 Sep 29.
BACKGROUND/AIMS: Studies have reported an association between fecal occult blood and increased all-cause, non-colorectal cancer (CRC) as well as CRC mortality. This study aimed to determine whether positive fecal immunochemistry test (FIT) results are associated with death from various causes in the South Korean population.
Using the Korean National Cancer Screening Program database, we collected data on patients who underwent FIT between 2009 and 2011.
Of the 5,932,544 participants, 380,789 (6.4%) had positive FIT results. FIT-positive participants had a higher mortality rate than FIT-negative participants from CRC (1.33 and 0.21 per 1,000 person-years, p < 0.001, respectively) and non-CRC causes (10.40 and 7.50 per 1,000 person-years, p < 0.001, respectively). Despite adjusting for age, sex, smoking status, alcohol consumption habits, body mass index, comorbidity, and aspirin use, FIT positivity was associated with an increased risk of dying from all non-CRC causes (adjusted hazard ratio [aHR], 1.17; 95% confidence interval [CI], 1.15 to 1.18) and CRC (aHR, 5.61; 95% CI, 5.40 to 5.84). Additionally, FIT positivity was significantly associated with increased mortality from circulatory disease (aHR, 1.14; 95% CI, 1.11 to 1.17), respiratory disease (aHR, 1.14; 95% CI, 1.09 to 1.19), digestive disease (aHR, 1.57; 95% CI, 1.48 to 1.66), neuropsychological disease (aHR, 1.08; 95% CI, 1.01 to 1.16), blood and endocrine diseases (aHR, 1.10; 95% CI, 1.04 to 1.17), and external factors (aHR, 1.16; 95% CI, 1.11 to 1.20).
Positive FIT results are associated with an increased risk of mortality from CRC and various other chronic diseases, suggesting that it could be a predictor of mortality independent of its association with CRC.
背景/目的:已有研究报告粪便潜血与全因、非结直肠癌(CRC)以及 CRC 死亡率的增加有关。本研究旨在确定在韩国人群中,粪便免疫化学检测(FIT)阳性结果是否与各种原因导致的死亡相关。
我们使用韩国国家癌症筛查计划数据库,收集了 2009 年至 2011 年间进行 FIT 检查的患者数据。
在 5932544 名参与者中,380789 名(6.4%)FIT 结果阳性。与 FIT 阴性者相比,FIT 阳性者的 CRC(每 1000 人年 1.33 比 0.21,p<0.001)和非 CRC 原因(每 1000 人年 10.40 比 7.50,p<0.001)死亡率更高。尽管调整了年龄、性别、吸烟状况、饮酒习惯、体重指数、合并症和阿司匹林使用情况,但 FIT 阳性与非 CRC 原因导致的死亡风险增加相关(校正后的危险比[aHR],1.17;95%置信区间[CI],1.15 至 1.18)和 CRC(aHR,5.61;95% CI,5.40 至 5.84)。此外,FIT 阳性与循环系统疾病(aHR,1.14;95% CI,1.11 至 1.17)、呼吸系统疾病(aHR,1.14;95% CI,1.09 至 1.19)、消化系统疾病(aHR,1.57;95% CI,1.48 至 1.66)、神经心理疾病(aHR,1.08;95% CI,1.01 至 1.16)、血液和内分泌疾病(aHR,1.10;95% CI,1.04 至 1.17)和外部因素(aHR,1.16;95% CI,1.11 至 1.20)的死亡率增加显著相关。
FIT 阳性结果与 CRC 和其他各种慢性疾病的死亡率增加相关,这表明它可能是独立于与 CRC 相关的死亡率的预测指标。