Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results - 20/06/12
Reprint requests: Sietze T. van Turenhout, MD, Department of Gastroenterology and Hepatology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the NetherlandsRésumé |
Background |
Colorectal cancer screening by fecal immunochemical tests (FITs) is hampered by frequent false-positive (FP) results and thereby the risk of complications and strain on colonoscopy capacity. Hemorrhoids might be a plausible cause of FP results.
Objective |
To determine the contribution of hemorrhoids to the frequency of FP FIT results.
Design |
Retrospective analysis from prospective cohort study.
Setting |
Five large teaching hospitals, including 1 academic hospital.
Patients |
All subjects scheduled for elective colonoscopy.
Interventions |
FIT before bowel preparation.
Main Outcome Measurements |
Frequency of FP FIT results in subjects with hemorrhoids as the only relevant abnormality compared with FP FIT results in subjects with no relevant abnormalities. Logistic regression analysis to determine colonic abnormalities influencing FP results.
Results |
In 2855 patients, 434 had positive FIT results: 213 had advanced neoplasia and 221 had FP results. In 9 individuals (4.1%; 95% CI, 1.4-6.8) with an FP FIT result, hemorrhoids were the only abnormality. In univariate unadjusted analysis, subjects with hemorrhoids as the only abnormality did not have more positive results (9/134; 6.7%) compared with subjects without any abnormalities (43/886; 4.9%; P = .396). Logistic regression identified hemorrhoids, nonadvanced polyps, and a group of miscellaneous abnormalities, all significantly influencing false positivity. Of 1000 subjects with hemorrhoids, 67 would have FP results, of whom 18 would have FP results because of hemorrhoids only.
Limitations |
Potential underreporting of hemorrhoids; high-risk individuals.
Conclusions |
Hemorrhoids in individuals participating in colorectal cancer screening will probably not lead to a substantial number of false-positive test results.
Le texte complet de cet article est disponible en PDF.Abbreviations : CRC, FIT, FOBT, FP, OR
Plan
| DISCLOSURE: The authors disclosed no financial relationships relevant to this publication. This research project was partially supported by an unrestricted grant of Nycomed BV, Hoofddorp to the Amsterdam Gutclub, the Netherlands. This company had no influence on any aspect relevant to this study. Dr. van Turenhout was supported by a research grant from the Centre for Translational Molecular Medicine, the Netherlands. F.A. Oort and J.S. Terhaar sive Droste were supported by a research grant of Nycomed BV. This foundation had no influence on any aspect relevant to this study. The OC sensor MICRO desktop analyzer was provided by Eiken Chemical Co, Tokyo, Japan. This company had no influence on any aspect relevant to this study. |
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| If you would like to chat with an author of this article, you may contact Dr van Turenhout at s.vanturenhout@vumc.nl |
Vol 76 - N° 1
P. 136-143 - juillet 2012 Retour au numéro
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