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Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort

We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohor...

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Autores principales: Pin-Vieito, Noel, Iglesias, María José, Remedios, David, Álvarez-Sánchez, Victoria, Fernández-Bañares, Fernando, Boadas, Jaume, Martínez-Bauer, Eva, Campo, Rafael, Bujanda, Luis, Ferrández, Ángel, Piñol, Virginia, Rodríguez-Alcalde, Daniel, Menéndez-Rodríguez, Martín, García-Morales, Natalia, Pérez-Mosquera, Cristina, Cubiella, Joaquín
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770570/
https://www.ncbi.nlm.nih.gov/pubmed/33276621
http://dx.doi.org/10.3390/diagnostics10121036
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author Pin-Vieito, Noel
Iglesias, María José
Remedios, David
Álvarez-Sánchez, Victoria
Fernández-Bañares, Fernando
Boadas, Jaume
Martínez-Bauer, Eva
Campo, Rafael
Bujanda, Luis
Ferrández, Ángel
Piñol, Virginia
Rodríguez-Alcalde, Daniel
Menéndez-Rodríguez, Martín
García-Morales, Natalia
Pérez-Mosquera, Cristina
Cubiella, Joaquín
author_facet Pin-Vieito, Noel
Iglesias, María José
Remedios, David
Álvarez-Sánchez, Victoria
Fernández-Bañares, Fernando
Boadas, Jaume
Martínez-Bauer, Eva
Campo, Rafael
Bujanda, Luis
Ferrández, Ángel
Piñol, Virginia
Rodríguez-Alcalde, Daniel
Menéndez-Rodríguez, Martín
García-Morales, Natalia
Pérez-Mosquera, Cristina
Cubiella, Joaquín
author_sort Pin-Vieito, Noel
collection PubMed
description We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 ± 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3–3.1), CRC (HR 4.4, 95% CI 1.1–17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0–2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3–5.8), rectal bleeding (OR 0.3, 95% CI 0.1–0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7–7.1). However, CEA was increased only in 31.8% (95% CI, 16.4–52.7%) and 50% (95% CI, 25.4–74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC.
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spelling pubmed-77705702020-12-30 Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort Pin-Vieito, Noel Iglesias, María José Remedios, David Álvarez-Sánchez, Victoria Fernández-Bañares, Fernando Boadas, Jaume Martínez-Bauer, Eva Campo, Rafael Bujanda, Luis Ferrández, Ángel Piñol, Virginia Rodríguez-Alcalde, Daniel Menéndez-Rodríguez, Martín García-Morales, Natalia Pérez-Mosquera, Cristina Cubiella, Joaquín Diagnostics (Basel) Article We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 ± 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3–3.1), CRC (HR 4.4, 95% CI 1.1–17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0–2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3–5.8), rectal bleeding (OR 0.3, 95% CI 0.1–0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7–7.1). However, CEA was increased only in 31.8% (95% CI, 16.4–52.7%) and 50% (95% CI, 25.4–74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC. MDPI 2020-12-02 /pmc/articles/PMC7770570/ /pubmed/33276621 http://dx.doi.org/10.3390/diagnostics10121036 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pin-Vieito, Noel
Iglesias, María José
Remedios, David
Álvarez-Sánchez, Victoria
Fernández-Bañares, Fernando
Boadas, Jaume
Martínez-Bauer, Eva
Campo, Rafael
Bujanda, Luis
Ferrández, Ángel
Piñol, Virginia
Rodríguez-Alcalde, Daniel
Menéndez-Rodríguez, Martín
García-Morales, Natalia
Pérez-Mosquera, Cristina
Cubiella, Joaquín
Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title_full Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title_fullStr Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title_full_unstemmed Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title_short Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort
title_sort predictive value of carcinoembryonic antigen in symptomatic patients without colorectal cancer: a post-hoc analysis within the colonpredict cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770570/
https://www.ncbi.nlm.nih.gov/pubmed/33276621
http://dx.doi.org/10.3390/diagnostics10121036
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