4.2 Article

Positive fecal immunochemical test results are associated with non-colorectal cancer mortality

Journal

KOREAN JOURNAL OF INTERNAL MEDICINE
Volume 37, Issue 2, Pages 313-+

Publisher

KOREAN ASSOC INTERNAL MEDICINE
DOI: 10.3904/kjim.2021.081

Keywords

Fecal immunochemical test; Mortality; Colorectal neoplasms

Funding

  1. National Research Founda-tion of Korea (NRF) - Korean government (MSIT) [2020R1A2C1010786, 2020R1A5A2019210]
  2. National Research Foundation of Korea [2020R1A2C1010786, 2020R1A5A2019210] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

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The study found that positive fecal immunochemistry test (FIT) results are associated with an increased risk of mortality from CRC and various other chronic diseases, suggesting that FIT could be a predictor of mortality independent of its association with CRC.
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 associ-ated with death from various causes in the South Korean population. Methods: Using the Korean National Cancer Screening Program database, we collected data on patients who underwent FIT between 2009 and 2011. Results: Of the 5,932,544 participants, 380,789 (6.4%) had positive FIT results. FIT -posi-tive 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), respi-ratory 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 endo-crine diseases (aHR, 1.10; 95% CI, 1.04 to 1.17), and external factors (aHR, 1.16; 95% CI, 1.11 to 1.20). Conclusions: 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 mortal-ity independent of its association with CRC.

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