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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7770570 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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