Abu-Freha Naim, Gouldner Rachel, Cohen Bracha, Gordon Michal, Sagi Orly, Taha Gadeer, Ben Shoshan Liza, Levi Zohar
The Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva 84105, Israel.
The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
Cancers (Basel). 2022 Nov 12;14(22):5557. doi: 10.3390/cancers14225557.
(1) Background: Fecal occult blood test (FOBT) is the modality of choice in most countries for colorectal cancer (CRC) screening. We aimed to investigate the risk factors for CRC among patients with a positive FOBT in real life. (2) Methods: This was a retrospective study that included patients who tested positive for FOBT. Data regarding the comorbidities and laboratories were collected and compared between CRC and non-CRC groups. (3) Results: Positive FOBT was found among 45,500 (5.36%) subjects and CRC was found in 1502 (3.3%). CRC patients were older, age 62.7 ± 7.15 years compared with 59.33 ± 7.3 years (p < 0.001), and had significantly higher rates of hypertension (48.4% vs. 44.7%, p = 0.002), iron-deficiency anemia (20.6% vs. 16.4, p < 0.001), family history of CRC (7.3% vs. 5.1%, p < 0.001), and previous CRC (6.5% vs. 0.3%, p < 0.001). Lower levels of hemoglobin, iron, and ferritin were found in the CRC group. Age, family history of CRC, and previous CRC were found to be significant risk factors for diagnosis of CRC after positive FOBT with OR of 1.057, 1.4, and 15.9, respectively. (4) Conclusions: Iron-deficiency anemia, family history of CRC, previous colorectal cancer, and low hemoglobin, iron, and ferritin levels should direct physicians to give high priority to colonoscopy scheduling.
(1) 背景:粪便潜血试验(FOBT)是大多数国家用于结直肠癌(CRC)筛查的首选方法。我们旨在调查现实生活中粪便潜血试验呈阳性的患者患结直肠癌的风险因素。(2) 方法:这是一项回顾性研究,纳入了粪便潜血试验呈阳性的患者。收集了合并症和实验室检查数据,并在结直肠癌组和非结直肠癌组之间进行比较。(3) 结果:在45500名(5.36%)受试者中发现粪便潜血试验呈阳性,其中1502人(3.3%)患有结直肠癌。结直肠癌患者年龄较大,平均年龄为62.7±7.15岁,而对照组为59.33±7.3岁(p<0.001),高血压发生率显著更高(48.4%对44.7%,p=0.002),缺铁性贫血发生率显著更高(20.6%对16.4%,p<0.001),结直肠癌家族史发生率显著更高(7.3%对5.1%,p<0.001),既往结直肠癌发生率显著更高(6.5%对0.3%,p<0.001)。结直肠癌组的血红蛋白、铁和铁蛋白水平较低。年龄、结直肠癌家族史和既往结直肠癌被发现是粪便潜血试验呈阳性后诊断结直肠癌的重要风险因素,其比值比分别为1.057、1.4和15.9。(4) 结论:缺铁性贫血、结直肠癌家族史、既往结直肠癌以及低血红蛋白、铁和铁蛋白水平应促使医生高度重视安排结肠镜检查。