Luis Bujanda1, Cristina Sarasqueta2, Pablo Vega3, María Salve3, Enrique Quintero4, Victoria Alvarez-Sánchez5, Fernando Fernández-Bañares6, Jaume Boadas7, Rafel Campo8, Ana Garayoa9, Angel Ferrandez10, Leyanira Torrealba11, Daniel Rodríguez-Alcaide12, Mauro D'Amato13, Vicent Hernández14,15, Joaquin Cubiella3,15. 1. Gastroenterology Department, Hospital Universitario Donostia/Biodonostia Institute, University of the Basque Country (UPV/EHU), San Sebastián, Spain; and Centro de Investigación en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain. 2. Hospital Universitario Donostia/ Biodonostia Institute, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), San Sebastián, Spain. 3. Gastroenterology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain. 4. Gastroenterology Department, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN). Departamento de Medicina Interna. Universidad de La Laguna, La Laguna, Spain. 5. Gastroenterology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain. 6. Gastroenterology Department, Hospital Universitario Mutua Terrassa and CIBEREHD, Terrassa, Spain. 7. Gastroenterology Department, Consorci Sanitari Terrassa, Spain. 8. Gastroenterology Department, Corporació Sanitària Parc Taulí and CIBERehd, Sabadell, Spain. 9. Gastroenterology Department, Hospital de Sagunto, Valencia, Spain. 10. Gastroenterology Department, Hospital Universitario Clínico de Zaragoza y CIBERehd, Zaragoza, Spain. 11. Gastroenterology Department, Hospital Dr. Josep Trueta, Girona, Spain. 12. Gastroenterology Department, Hospital Universitario de Móstoles, Madrid, Spain. 13. Biodonostia Institute, San Sebastian and IKERBASQUE, The Basque Science Foundation, Bilbao, Spain. 14. Gastroenterology Department, Complexo Hospitalario Universitario de Vigo, Spain. 15. Instituto de Investigación Biomédica Ourense, Pontevedra e Vigo, Spain.
Abstract
BACKGROUND: Aspirin (ASA) is a drug that can cause gastrointestinal lesions and symptoms. Colorectal cancer (CRC) is the most prevalent type of cancer in Western countries. We assessed the effect of aspirin on the diagnostic accuracy of the faecal immunochemical test (FIT) for CRC and/or advanced neoplasia (AN) in patients undergoing colonoscopy for gastrointestinal symptoms. METHODS: We conducted a prospective multicentre observational study of diagnostic tests that included patients with gastrointestinal symptoms undergoing colonoscopy between March 2012 and 2014 (the COLONPREDICT study). Symptoms were assessed and a FIT and blood tests assessing haemoglobin and carcinoembryonic antigen (CEA) levels were performed. RESULTS: The study included 3052 patients: A total of 2567 did not take aspirin (non-user group) and 485 (16%) took aspirin (user group). Continuous treatment with ASA did not change the AUC (0.88, 0.82; p = 0.06), sensitivity (92%, 88%; p = 0.5) or specificity (71%, 67%; p = 0.2) of the FIT for CRC detection. Similarly, we found no differences in the AUC (0.81, 0.79; p = 0.6), sensitivity (74%, 75.5%; p = 0.3) or specificity (76%, 73.6%; p = 0.3) for AN detection. Patients with an aspirin use of ≥ 300 mg/day had a lower prevalence of AN and the sensitivity, specificity and AUC for AN for these patients were 54%, 68% and 0.66, significantly lower than for the non-user group (p = 0.03). CONCLUSIONS: Aspirin does not modify the diagnostic accuracy of FIT for CRC and/or AN in patients with gastrointestinal symptoms. Aspirin use of ≥ 300 mg/day decreases the accuracy of the test.
BACKGROUND: Aspirin (ASA) is a drug that can cause gastrointestinal lesions and symptoms. Colorectal cancer (CRC) is the most prevalent type of cancer in Western countries. We assessed the effect of aspirin on the diagnostic accuracy of the faecal immunochemical test (FIT) for CRC and/or advanced neoplasia (AN) in patients undergoing colonoscopy for gastrointestinal symptoms. METHODS: We conducted a prospective multicentre observational study of diagnostic tests that included patients with gastrointestinal symptoms undergoing colonoscopy between March 2012 and 2014 (the COLONPREDICT study). Symptoms were assessed and a FIT and blood tests assessing haemoglobin and carcinoembryonic antigen (CEA) levels were performed. RESULTS: The study included 3052 patients: A total of 2567 did not take aspirin (non-user group) and 485 (16%) took aspirin (user group). Continuous treatment with ASA did not change the AUC (0.88, 0.82; p = 0.06), sensitivity (92%, 88%; p = 0.5) or specificity (71%, 67%; p = 0.2) of the FIT for CRC detection. Similarly, we found no differences in the AUC (0.81, 0.79; p = 0.6), sensitivity (74%, 75.5%; p = 0.3) or specificity (76%, 73.6%; p = 0.3) for AN detection. Patients with an aspirin use of ≥ 300 mg/day had a lower prevalence of AN and the sensitivity, specificity and AUC for AN for these patients were 54%, 68% and 0.66, significantly lower than for the non-user group (p = 0.03). CONCLUSIONS: Aspirin does not modify the diagnostic accuracy of FIT for CRC and/or AN in patients with gastrointestinal symptoms. Aspirin use of ≥ 300 mg/day decreases the accuracy of the test.
Entities:
Keywords:
FIT; Faecal immunochemical test; advanced neoplasia; aspirin; colorectal cancer
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