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Positive faecal immunochemical test predicts the onset of inflammatory bowel disease: A nationwide, propensity score-matched study

Authors
 Eunyoung Lee  ;  Gil Ho Lee  ;  Bumhee Park  ;  Sung Soo Ahn  ;  Choong-Kyun Noh 
Citation
 FRONTIERS IN IMMUNOLOGY, Vol.14 : 1128736, 2023-02 
Journal Title
FRONTIERS IN IMMUNOLOGY
Issue Date
2023-02
MeSH
Colitis, Ulcerative* / diagnosis ; Colitis, Ulcerative* / epidemiology ; Crohn Disease* ; Humans ; Inflammation ; Inflammatory Bowel Diseases* / diagnosis ; Inflammatory Bowel Diseases* / epidemiology ; Mucositis* ; Propensity Score
Keywords
faecal immunochemical test ; incidence ; inflammatory bowel disease ; prediction ; risk
Abstract
Background & aims: The faecal immunochemical test (FIT), a non-invasive test for screening colorectal cancer (CRC), is being increasingly understood to reflect heightened inflammation. We aimed to investigate the association between abnormal FIT results and onset of inflammatory bowel disease (IBD), a disease characterized with chronic gut mucosal inflammation.

Methods: Participants in the Korean National Cancer Screening Program for CRC between 2009-2013 were analysed and divided into positive and negative FIT result groups. The incidence rates of IBD after screening were calculated after excluding cases of haemorrhoids, CRC, and IBD at baseline. Cox proportional hazard analyses were used to identify independent risk factors for IBD occurrence during follow-up, and 1:2 propensity score matching was performed as a sensitivity analysis.

Results: In total, 229,594 and 815,361 participants were assigned to the positive and negative FIT result groups, respectively. The age- and sex-adjusted incidence rates of IBD in participants with positive and negative test results were 1.72 and 0.50 per 10,000 person-years, respectively. Adjusted Cox analysis revealed that FIT positivity was associated with a significantly higher risk of IBD (hazard ratio 2.93, 95% confidence interval: 2.46, 3.47, P <.001), which was consistent for both disease subtypes of ulcerative colitis and Crohn's disease. The results of Kaplan-Meier analysis in the matched population yielded identical findings.

Conclusions: Abnormal FIT results could be a preceding sign of incident IBD in the general population. Those with positive FIT results and suspected IBD symptoms could benefit from regular screening for early disease detection.
Files in This Item:
T202301341.pdf Download
DOI
10.3389/fimmu.2023.1128736
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193647
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