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Medical Oncology
Published in: Medical Oncology 9/2014

01-09-2014 | Original Paper

Sex is a stronger predictor of colorectal adenoma and advanced adenoma than fecal occult blood test

Authors: Monika Ferlitsch, Georg Heinze, Petra Salzl, Martha Britto-Arias, Elisabeth Waldmann, Karoline Reinhart, Christina Bannert, Elisabeth Fasching, Peter Knoflach, Werner Weiss, Michael Trauner, Arnulf Ferlitsch

Published in: Medical Oncology | Issue 9/2014

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Abstract

Due to high costs and limited availability of screening colonoscopy, some screening programs require a positive fecal occult blood test (FOBT) before screening colonoscopy is remunerated. As male sex is a strong predictor of adenoma and advanced adenoma, we evaluated whether a positive FOBT or male sex is a stronger risk factor for adenoma and advanced adenoma. FOBT and screening colonoscopy results from 18.665 consecutive patients participating in a “national health check program” between 2009 and 2011 were included in this cohort study. Age-corrected adenoma detection rates (ADR), advanced adenoma detection rates (AADR) and carcinoma detection rates were calculated for men and women according to FOBT result separately. ADR and AADR in FOBT-positive men (34.6 and 11.8 %) and FOBT-negative men (29.1 and 7.6 %) were higher than ADR and AADR in FOBT-positive women (20 and 6.9 %) and in FOBT-negative women (17.6 and 4.4 %), (p = 0.0003). Men with negative FOBT were at higher risk of having an adenoma and advanced adenoma than women with positive FOBT (p < 0.0001). Odds ratios of a positive FOBT for ADR and AADR were 1.3 (1.1–1.5) (p = 0.0047) and 1.6 (1.2–2.1) (p < 0.0001), respectively. Odds ratios of male sex to predict ADR and AADR were significantly higher with 1.9 (1.8–2.1) and 1.8 (1.6–2), respectively (p < 0.001). Male sex is a stronger predictor for colorectal adenoma and advanced adenoma than positive FOBT. These results should be taken into account analyzing FOBT-based screening programs.
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Metadata
Title
Sex is a stronger predictor of colorectal adenoma and advanced adenoma than fecal occult blood test
Authors
Monika Ferlitsch
Georg Heinze
Petra Salzl
Martha Britto-Arias
Elisabeth Waldmann
Karoline Reinhart
Christina Bannert
Elisabeth Fasching
Peter Knoflach
Werner Weiss
Michael Trauner
Arnulf Ferlitsch
Publication date
01-09-2014
Publisher
Springer US
Published in
Medical Oncology / Issue 9/2014
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-014-0151-0

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