Jayne Digby1, Paula J McDonald2, Judith A Strachan2, Gillian Libby1, Robert J C Steele3, Callum G Fraser4. 1. Scottish Bowel Screening Research Unit, University of Dundee, Dundee, Scotland. 2. Scottish Bowel Screening Centre Laboratory, Kings Cross, Dundee, Scotland. 3. Medical Research Institute, University of Dundee, Dundee, Scotland. 4. Centre for Research into Cancer Prevention & Screening, University of Dundee, Dundee, Scotland callum.fraser@nhs.net.
Abstract
OBJECTIVE: To investigate the relationship between deprivation and faecal haemoglobin concentration (f-Hb). SETTING: Scottish Bowel Screening Programme. METHODS: A total of 66725 men and women, aged 50 to 74, were invited to provide a single sample for a faecal immunochemical test. Deprivation was estimated using the Scottish Index of Multiple Deprivation quintiles: f-Hb was measured (OC-Sensor, Eiken, Japan) on 38439 participants. The relationship between deprivation quintiles and f-Hb was examined. RESULTS: Median age was 60 years, 53.6% women, with 14.1%, 19.7%, 17.7%, 25.9% and 22.6% in the lowest to the highest deprivation quintiles respectively. No detectable f-Hb was found in 51.9%, ranging from 45.5% in the most deprived up to 56.5% in the least deprived. As deprivation increased, f-Hb increased (p < 0.0001). This trend remained controlling for sex and age (p < 0.001). Participants in the most deprived quintile were more likely to have a f-Hb above a cut-off of 80 µg Hb/g faeces compared with the least deprived, independent of sex and age (adjusted odds ratio 1.70, 95% confidence interval: 1.37 to 2.11). CONCLUSIONS: Deprivation and f-Hb are related. This has important implications for selection of cut-off f-Hb for screening programmes, and supports the inclusion of deprivation in risk-scoring systems.
OBJECTIVE: To investigate the relationship between deprivation and faecal haemoglobin concentration (f-Hb). SETTING: Scottish Bowel Screening Programme. METHODS: A total of 66725 men and women, aged 50 to 74, were invited to provide a single sample for a faecal immunochemical test. Deprivation was estimated using the Scottish Index of Multiple Deprivation quintiles: f-Hb was measured (OC-Sensor, Eiken, Japan) on 38439 participants. The relationship between deprivation quintiles and f-Hb was examined. RESULTS: Median age was 60 years, 53.6% women, with 14.1%, 19.7%, 17.7%, 25.9% and 22.6% in the lowest to the highest deprivation quintiles respectively. No detectable f-Hb was found in 51.9%, ranging from 45.5% in the most deprived up to 56.5% in the least deprived. As deprivation increased, f-Hb increased (p < 0.0001). This trend remained controlling for sex and age (p < 0.001). Participants in the most deprived quintile were more likely to have a f-Hb above a cut-off of 80 µg Hb/g faeces compared with the least deprived, independent of sex and age (adjusted odds ratio 1.70, 95% confidence interval: 1.37 to 2.11). CONCLUSIONS: Deprivation and f-Hb are related. This has important implications for selection of cut-off f-Hb for screening programmes, and supports the inclusion of deprivation in risk-scoring systems.
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