Medical Oncology

, 31:151

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

  • 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
Original Paper

DOI: 10.1007/s12032-014-0151-0

Cite this article as:
Ferlitsch, M., Heinze, G., Salzl, P. et al. Med Oncol (2014) 31: 151. doi:10.1007/s12032-014-0151-0

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.

Keywords

Fecal occult blood test Screening colonoscopy Adenoma detection rate Advanced adenoma detection rate 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Monika Ferlitsch
    • 1
    • 2
  • Georg Heinze
    • 3
  • Petra Salzl
    • 1
    • 2
  • Martha Britto-Arias
    • 1
    • 2
  • Elisabeth Waldmann
    • 1
    • 2
  • Karoline Reinhart
    • 1
    • 2
  • Christina Bannert
    • 1
    • 2
  • Elisabeth Fasching
    • 4
  • Peter Knoflach
    • 1
  • Werner Weiss
    • 1
  • Michael Trauner
    • 1
    • 2
  • Arnulf Ferlitsch
    • 1
    • 2
  1. 1.Quality Assurance Working GroupAustrian Society of Gastroenterology and HepatologyViennaAustria
  2. 2.Div of Gastroenterology and Hepatology, Internal Medicine IIIMedical University ViennaViennaAustria
  3. 3.Div of Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent SystemsMedical University of ViennaViennaAustria
  4. 4.Main Association of Austrian Social Insurance InstitutionsViennaAustria

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