Anatomical location of colorectal neoplasia in patients with positive stool test (multitarget stool DNA or fecal immunochemical test) results: data from the New Hampshire Colonoscopy Registry.
Joseph C Anderson, William M Hisey, Christina M Robinson, Paul J Limburg, Bonny L Kneedler, Lynn F Butterly
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引用次数: 0
Abstract
Background and aims: Data comparing the location of polyp yield in patients with positive stool test results can aid screening test selection. We conducted a cross-sectional analysis of New Hampshire Colonoscopy Registry data to compare the location, left versus right side of the colon, of neoplasia detected on colonoscopy after a multitarget stool DNA (mt-sDNA) test or a fecal immunochemical test (FIT), compared with a reference group undergoing colonoscopy without a stool test.
Methods: Our outcomes were advanced lesions (adenomas and/or serrated polyps, including cancer), advanced adenomas, or advanced serrated polyps stratified by location. We examined the prevalence of left- versus right-sided lesions across 3 cohorts.
Results: As compared to colonoscopy (n = 68,645), both FIT+ (n = 584) and mt-sDNA+ (n = 1176) patients had higher proportions of advanced lesions and advanced adenomas on both sides of the colon (P < .001). Mt-sDNA+ patients had significantly higher risks for right-sided advanced serrated polyps (odds ratio [OR] = 3.21; 95% confidence interval [CI], 2.67-3.85; colonoscopy [reference]) and right-sided advanced lesions (OR = 3.13; 95% CI, 2.66-3.68; colonoscopy [reference]) as compared to FIT+ (advanced serrated polyps: OR = 1.38; 95% CI, 0.99-1.99 and advanced lesions: OR = 1.84; 95% CI, 1.43-2.37) or colonoscopy (reference). In our main analysis, the colonoscopy-only group had significantly higher odds of each outcome on the right side than the left side; in comparison, the odds for FIT+ and mt-sDNA+ patients were more evenly distributed throughout the colon.
Conclusions: Our data suggest that FIT+ tests are associated with higher detection of both right- and left-sided advanced adenomas as compared to colonoscopy without a prior stool test. Furthermore, mt-sDNA+ patients had higher proportions of left- and right-sided advanced adenomas and advanced serrated polyps, particularly on the right side.
期刊介绍：
Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.
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