TY - JOUR
T1 - Cause of Death, Mortality and Occult Blood in Colorectal Cancer Screening
AU - Kaalby, Lasse
AU - Al-Najami, Issam
AU - Deding, Ulrik
AU - Berg-Beckhoff, Gabriele
AU - Steele, Robert J. C.
AU - Kobaek-Larsen, Morten
AU - Shaukat, Aasma
AU - Rasmussen, Morten
AU - Baatrup, Gunnar
N1 - Funding Information:
Funding: The Danish Cancer Society (R100-A6747), Odense University Hospital (A3472/A2359), the US Department of Veterans Affairs (36C24E18P0155) and the University of Southern Denmark supported this study.
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/1/4
Y1 - 2022/1/4
N2 - Fecal hemoglobin (f-Hb) detected by the guaiac fecal occult blood test (gFOBT) may be associated with mortality and cause of death in colorectal cancer (CRC) screening participants. We investigated this association in a randomly selected population of 20,694 participants followed for 33 years. We followed participants from the start of the Hemoccult-II CRC trial in 1985-1986 until December 2018. Data on mortality, cause of death and covariates were retrieved using Danish national registers. We conducted multivariable Cox regressions with time-varying exposure, reporting results as crude and adjusted hazard ratios (aHRs). We identified 1766 patients with at least one positive gFOBT, 946 of whom died in the study period. Most gFOBT-positive participants (93.23%) died of diseases unrelated to CRC and showed higher non-CRC mortality than gFOBT-negative participants (aHR: 1.20, 95% CI 1.10-1.30). Positive gFOBT participants displayed a modest increase in all-cause (aHR: 1.28, 95% CI: 1.18-1.38), CRC (aHR: 4.07, 95% CI: 3.00-5.56), cardiovascular (aHR: 1.22, 95% CI: 1.07-1.39) and endocrine and hematological mortality (aHR: 1.58, 95% CI: 1.19-2.10). In conclusion, we observed an association between positive gFOBT, cause of death and mortality. The presence of f-Hb in the gFOBT might indicate the presence of systemic diseases.
AB - Fecal hemoglobin (f-Hb) detected by the guaiac fecal occult blood test (gFOBT) may be associated with mortality and cause of death in colorectal cancer (CRC) screening participants. We investigated this association in a randomly selected population of 20,694 participants followed for 33 years. We followed participants from the start of the Hemoccult-II CRC trial in 1985-1986 until December 2018. Data on mortality, cause of death and covariates were retrieved using Danish national registers. We conducted multivariable Cox regressions with time-varying exposure, reporting results as crude and adjusted hazard ratios (aHRs). We identified 1766 patients with at least one positive gFOBT, 946 of whom died in the study period. Most gFOBT-positive participants (93.23%) died of diseases unrelated to CRC and showed higher non-CRC mortality than gFOBT-negative participants (aHR: 1.20, 95% CI 1.10-1.30). Positive gFOBT participants displayed a modest increase in all-cause (aHR: 1.28, 95% CI: 1.18-1.38), CRC (aHR: 4.07, 95% CI: 3.00-5.56), cardiovascular (aHR: 1.22, 95% CI: 1.07-1.39) and endocrine and hematological mortality (aHR: 1.58, 95% CI: 1.19-2.10). In conclusion, we observed an association between positive gFOBT, cause of death and mortality. The presence of f-Hb in the gFOBT might indicate the presence of systemic diseases.
KW - Cause of death
KW - Colorectal cancer
KW - Fecal hemoglobin
KW - Mortality
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85122073788&partnerID=8YFLogxK
U2 - 10.3390/cancers14010246
DO - 10.3390/cancers14010246
M3 - Article
C2 - 35008412
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 1
M1 - 246
ER -
