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Colorectal cancer risk quantified by faecal occult blood tests

By Alisdair Stirling

Faecal occult blood tests could be used to stratify patients' risk of developing colorectal cancer into low, medium or high risk, a new study suggests.

Researchers carried out a prospective cohort study involving 46,000 patients aged between 40 and 69 tested using immunochemical faecal occult blood testing between 2001 and 2007.

A total of 44,324 had a negative test result of less than 100ng/mL, and these patients were followed for a median of 4.4 years.

Patients with a baseline faecal haemoglobin concentration between 20 and 39 ng/mL had a 43% increased risk of neoplasia compared to those with a concentration below 20 ng/mL. The risk rose to 3.4 times higher in those with a baseline concentration of 80–99 ng/mL.

Study leader Dr Li-Sheng Chen, an epidemiologist at the University of Taipei in Taiwan, concluded: 'Risk stratification based on faecal haemoglobin could help clinicians pay particular attention to those with higher initial faecal haemoglobin concentrations, especially those just under the threshold taken to indicate presence of colorectal cancer.'

Lancet Oncology 2011, online 17 May

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