The effect of using fecal testing after a negative sigmoidoscopy on the risk of death from colorectal cancer.

Details

Serval ID
serval:BIB_4E760605DB5D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The effect of using fecal testing after a negative sigmoidoscopy on the risk of death from colorectal cancer.
Journal
Journal of medical screening
Author(s)
Doubeni C.A., Corley D.A., Jensen C.D., Schottinger J.E., Lee J.K., Ghai N.R., Levin T.R., Zhao W.K., Saia C.A., Wainwright J.V., Mehta S.J., Selby K., Doria-Rose V.P., Zauber A.G., Fletcher R.H., Weiss N.S.
ISSN
1475-5793 (Electronic)
ISSN-L
0969-1413
Publication state
In Press
Peer-reviewed
Oui
Pages
969141320921427
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
To examine whether receiving a fecal occult blood test after a negative sigmoidoscopy reduced mortality from colorectal cancer.
We used a nested case-control design with incidence-density matching in historical cohorts of 1,877,740 50-90-year-old persons during 2006-2012, in an integrated health-system setting. We selected 1758 average risk patients who died from colorectal cancer and 3503 matched colorectal cancer-free persons. Colorectal cancer-specific death was ascertained from cancer and mortality registries. Screening histories were determined from electronic and chart-audit clinical data in the 5- to 10-year period prior to the reference date. We evaluated receipt of subsequent fecal occult blood test within five years of the reference date among patients with negative sigmoidoscopy two to six years before the reference date.
Of the 5261 patients, 831 patients (204 colorectal cancer deaths/627 controls) had either negative sigmoidoscopy only (n = 592) or negative sigmoidoscopy with subsequent screening fecal occult blood test (n = 239). Fifty-six (27.5%) of the 204 patients dying of colorectal cancer and 183 (29.2%) of the 627 colorectal cancer-free patients received fecal occult blood test following a negative sigmoidoscopy. Conditional regressions found no significant association between fecal occult blood test receipt and colorectal cancer death risk, overall (adjusted odds ratio = 0.93, confidence interval: 0.65-1.33), or for right (odds ratio = 1.02, confidence interval: 0.65-1.60) or left-colon/rectum (odds ratio = 0.77, confidence interval: 0.39-1.52) cancers. Similar results were obtained in sensitivity analyses with alternative exposure ascertainment windows or timing of fecal occult blood test.
Our results suggest that receipt of at least one fecal occult blood test during the several years after a negative sigmoidoscopy did not substantially reduce mortality from colorectal cancer.
Keywords
Early detection of cancer, Endoscopy, Gastrointestinal, occult blood, Colorectal Neoplasms, comparative effectiveness, historical cohort, case control study
Pubmed
Web of science
Open Access
Yes
Create date
04/06/2020 9:14
Last modification date
18/06/2020 6:26
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