Screening Women Aged 50-59 for CRC Using Fecal Occult Blood Test Produces Outcomes Similar to Men Undergoing Screening Colonoscopy. Dig Dis Sci 2018 Oct;63(10):2780-2785
Date
06/28/2018Pubmed ID
29948570DOI
10.1007/s10620-018-5156-7Scopus ID
2-s2.0-85048457996 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Average-risk women aged 50-59 years have a lower incidence and mortality of colorectal cancer relative to age-matched men, calling into question the benefit of screening colonoscopy in this age group.
AIMS: We aimed to determine whether FOBT is an effective initial screening test in 50-59-year-old women.
METHODS: We conducted a cross-sectional study using a computerized endoscopic report generator. We identified 320,906 individuals who had average-risk screening colonoscopy and 32,369 who had colonoscopy for positive FOBT. The primary outcome was the positive predictive value (PPV) of FOBT for large polyp(s) greater than 9 mm, as a surrogate for advanced neoplasia.
RESULTS: Among patients aged 50-59 years undergoing screening colonoscopy, men were more likely than women to have large polyps (6.3 vs 4.2%, p < 0.0001). Black women undergoing screening colonoscopy had higher rates of large polyps compared to non-Black women. The PPV in FOBT-positive men aged 50-54 (11.5%) and 55-59 (14.4%) was higher than in women aged 50-54 (6.1%) and 55-59 (5.4%). Despite this lower PPV, women aged 50-54 with a positive FOBT had a similar rate of large polyps as 50-54-year-old men undergoing screening colonoscopy (6.1 vs 6.3%, p = 0.626).
CONCLUSIONS: CRC screening with FOBT identifies 50-59-year-old men and women with a higher risk of large polyps. Since younger women have a lower risk of large polyps than men, screening with FOBT in 50-59-year-old non-Black women could be an effective screening strategy, with outcomes similar to the use of screening colonoscopy in 50-59-year-old men.
Author List
Mooers HM, Holub JL, Lieberman DAAuthor
Harrison Mooers MD Staff Physician in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Age FactorsColonic Polyps
Colonoscopy
Colorectal Neoplasms
Early Detection of Cancer
Female
Humans
Incidence
Male
Mass Screening
Middle Aged
Risk Assessment
Sex Factors
United States
