Faecal haemoglobin concentrations are associated with all-cause mortality and cause of death in colorectal cancer screening

BMC Medicine

Research Article

Robert J. C. Steele¹  Issam Al-Najami²  Morten Kobaek-Larsen³  Gunnar Baatrup³  Ulrik Deding³  Anastasios Koulaouzidis³  Thomas Bjørsum-Meyer³  Lasse Kaalby³  Morten Rasmussen⁴  Aasma Shaukat⁵  Tinne Laurberg⁶  Gabriele Berg-Beckhoff⁷ 

[1] Centre for Research into Cancer Prevention and Screening, University of Dundee School of Medicine, DD1 9SY, Dundee, UK;Department of Surgery, Odense University Hospital, 5000, Odense, Denmark;Department of Surgery, Odense University Hospital, 5000, Odense, Denmark;Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark;Digestive Disease Center, Bispebjerg University Hospital, 2400, Copenhagen, Denmark;GI Section, Minneapolis VA Medical Center and University of Minnesota, 55417, Minneapolis, MN, USA;Division of Gastroenterology NYU Langone, 10016, New York, NY, USA;Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark;Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, 6700, Esbjerg, Denmark;Unit for Health Research, Hospital South West Jutland, 6700, Esbjerg, Denmark;

关键词: cause of death;    colorectal cancer screening;    faecal immunochemical test;    faecal haemoglobin;    mortality;    occult blood;   

DOI  :  10.1186/s12916-022-02724-3

 received in 2022-07-12, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundColorectal cancer (CRC) screening reduces all-cause and CRC-related mortality. New research demonstrates that the faecal haemoglobin concentration (f-Hb) may indicate the presence of other serious diseases not related to CRC. We investigated the association between f-Hb, measured by a faecal immunochemical test (FIT), and both all-cause mortality and cause of death in a population-wide cohort of screening participants.MethodsBetween 2014 and 2018, 1,262,165 participants submitted a FIT for the Danish CRC screening programme. We followed these participants, using the Danish CRC Screening Database and several other national registers on health and population, until December 31, 2018. We stratified participants by f-Hb and compared them using a Cox proportional hazards regression on all-cause mortality and cause of death reported as adjusted hazard ratios (aHRs). We adjusted for several covariates, including comorbidity, socioeconomic factors, demography and prescription medication.ResultsWe observed 21,847 deaths in the study period. Our multivariate analyses indicated an association relationship between increasing f-Hb and the risk of dying in the study period. This risk increased steadily from aHR 1.38 (95% CI: 1.32, 1.44) in those with a f-Hb of 7.1–11.9 μg Hb/g faeces to 2.20 (95% CI: 2.10, 2.30) in those with a f-Hb ≥60.0 μg Hb/g faeces, when compared to those with a f-Hb ≤7.0 μg Hb/g faeces. The pattern remained when excluding CRC from the analysis. Similar patterns were observed between incrementally increasing f-Hb and the risk of dying from respiratory disease, cardiovascular disease and cancers other than CRC. Furthermore, we observed an increased risk of dying from CRC with increasing f-Hb.ConclusionsOur findings support the hypothesis that f-Hb may indicate an elevated risk of having chronic conditions if causes for the bleeding have not been identified. The mechanisms still need to be established, but f-Hb may be a potential biomarker for several non-CRC diseases.

【 授权许可】

CC BY   
© The Author(s) 2023

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