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Impact of antithrombotics on the fecal immunochemical test for colorectal cancer screening : a multi-center Belgian experience

Journal Volume 84 - 2021
Issue Fasc.1 - Original articles
Author(s) L. Wauters 1, V.R.H. Van der Voort 2, P. Dobbels 3, K. Hendrickx 3, V. Casneuf 3 4, J. Vandervoort 3
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PAGES 19-24
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Affiliations:
(1) Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium and Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
(2) Department of Gastroenterology, UMC Utrecht, Utrecht, The Netherlands
(3) Department of Gastroenterology, OLV Hospitals Aalst/Asse/Ninove, Aalst, Belgium
(4) Department of Gastroenterology, UZ Gent, Gent, Belgium

Background: Impact of antithrombotics on the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening remains unclear.

Methods: Patients undergoing colonoscopy for positive FIT in 2015 were assessed at 3 Belgian centers. Significant findings were advanced polyps (AP) (sessile serrated, tubular or villous adenomas >1cm or high-grade dysplasia) and CRC. False positive FIT and detection of AP/CRC with antithrombotics were calculated.

Results: 510 patients (64% male, median (IQR) age 63.2 (60.2 - 66.4) years) were included. Colorectal pathology in 371/510 (73%) was associated with male gender (70% vs. 48% ; p= .0001) and family history (16% vs. 8% ; p= .02). Antithrombotics in 125/510 (25%) were associated with male gender (78% vs. 59% ; p= .0001), older age (65.2 (62.2-70.3) vs. 62.3 (58.7-66.3) years ; p= .0001) and GI-symptoms (18% vs. 11% ; p= .04). False positive FIT (25% vs. 28% ; p= .52) and detection of AP (42% vs. 36% ; p=.27) or CRC (6% vs. 5% ; p= .69) were similar in patients with vs. no antithrombotics. Use of antithrombotics did not predict a higher chance of colorectal pathology after adjusting for confounders.

Conclusion: Although antithrombotics were prescribed more frequently in male and older patients, detection of AP/CRC was similar. Despite increased GI symptoms, false positive FIT was similar with antithrombotics.

Keywords: antithrombotics, aspirin, colon cancer, fecal immunochemical test, screening.

© Acta Gastro-Enterologica Belgica.
PMID 33639689