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Stool-Based Colorectal Cancer Screening Test Performance Characteristics in Those With and Without Hemorrhoids

OBJECTIVE: To evaluate the effect of hemorrhoids on noninvasive stool test performance for colorectal cancer (CRC) screening. PATIENTS AND METHODS: We conducted a retrospective cohort study of test characteristics for the fecal immunochemical test (FIT) and the multitarget stool DNA (mt-sDNA) test,...

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Detalles Bibliográficos
Autores principales: Ebner, Derek W., Rushlow, David, Mou, Joshua, Porter, Kyle, Finney Rutten, Lila J., Limburg, Paul, Sancar, Feyza, Imperiale, Thomas F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10371761/
https://www.ncbi.nlm.nih.gov/pubmed/37502338
http://dx.doi.org/10.1016/j.mayocpiqo.2023.06.003
Descripción
Sumario:OBJECTIVE: To evaluate the effect of hemorrhoids on noninvasive stool test performance for colorectal cancer (CRC) screening. PATIENTS AND METHODS: We conducted a retrospective cohort study of test characteristics for the fecal immunochemical test (FIT) and the multitarget stool DNA (mt-sDNA) test, on the basis of hemorrhoid status, recorded at the time of colonoscopy, among patients enrolled in the pivotal prospective study for mt-sDNA that was conducted from June 2011, to May 2013. Test characteristics (sensitivity, specificity, positive, and negative predictive values) for FIT and mt-sDNA (performed < 90 days before colonoscopy) were stratified by the presence of hemorrhoids and compared. RESULTS: Hemorrhoids were found in 51.7% (5163 of 9989) of the study cohort. Across all test characteristics, there were no statistically significant differences for FIT or mt-sDNA when stratified by hemorrhoid status. Analysis revealed mt-sDNA sensitivity of 44% and 41% for advanced precancerous lesions in nonhemorrhoidal and hemorrhoid patients, respectively (P=.41). The FIT sensitivity among the same lesion category was 24.9% in patients without hemorrhoids and 22.8% in those with hemorrhoids (P=.48). The mt-sDNA specificity was 86.4% in patients without hemorrhoids vs 87.7% in those with hemorrhoids (P=.67), although FIT specificity was 95.0% among patients without hemorrhoids vs 94.7% in those with hemorrhoids (P=.44). CONCLUSION: The presence of asymptomatic hemorrhoids did not adversely affect test performance in this large clinical study. These findings suggest that in the absence of overt gastrointestinal bleeding, FIT and mt-sDNA are options for CRC screening, irrespective of hemorrhoid status. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01397747: