FIT Hemoglobin Predicts Risk of Advanced Neoplasia

They analyzed data from 7,663 participants screened at least once and found to have a negative FIT result at baseline (below the cut-off value of 10 μg Hb/ gram of feces [G]). Participants were followed for a median of 4.7 years (interquartile range, 2.0-6.1 years).

The investigators found that participants with two consecutive FIT Hb concentrations equal to or greater than 8 µg/G had a 14-fold increased risk of AN compared to those with baseline concentrations of 0 µg/G. Multi-variate hazard ratios increased from 1.2 for participants with FIT Hb concentrations 0–2 µg/G to 8.2 for those with concentrations 8–10 µg/G. This rising cumulative incidence of AN based on elevated FIT Hb levels was more prominent for Hb concentrations between 4 µg/G and 10 µg/G.

The authors concluded that in a population-based study of average-risk individuals with a FIT result below the cut-off value,they associated baseline concentrations of 8-10 μg fecal Hb/G with an increased risk of AN compared with baseline concentrations of 0 μg fecal Hb/G. Baseline and consecutive fecal Hb concentrations are independent predictors for incident AN. This information might be used in designing personalized strategies for population-based CRC screening and reduce unnecessary repeat tests. The study was originally published on July 28, 2017, in the journal Gastroenterology.

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