Adherence to follow-up examination after positive fecal occult blood test results affects colorectal cancer mortality: A Korea population-based cohort study

Yu Jin Kim, Jeong Im Shim, Eunjung Park, Minjoo Kang, Sinhee Kang, Jessie Lee, Ha Jin Tchoe, Kyeong Ae Kong, Duk Hwan Kim, Byung Chang Kim, Kui Son Choi, Chang Mo Moon

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: The impact of adherence to follow-up examination after a fecal occult blood test (FOBT) remains ill-defined. Aim: To evaluate the impact of adherence to the follow-up examination on clinical outcomes in individuals with positive FOBT results. Methods: This was a retrospective cohort study involving Korean individuals aged 50 years or older who participated in the National Cancer Screening Program for CRC from 2009 to 2010. Individuals who underwent a confirmative examination within a year after positive FOBT results were included in compliant group, and those who did not were included in non-compliant group. The incidence and stage of CRC, and 5-year survival were compared between two groups. Results: 5,914 were diagnosed with CRC in the compliant group and 2,973 in the non-compliant group. The proportion of advanced-stage CRC was significantly higher in the non-compliant group (localized CRC 44.6% vs. 36.7% and distant CRC 8.7% vs. 12.5%, p< 0.0001). The survival probability within 5 years was 71.0% in the non-compliant group and 85.9% in the compliant group (hazard ratio 1.70, 95% CI, 1.52–1.90, p< 0.001). Conclusion: Individuals who underwent follow-up examination 1 year or more after positive FOBT had a lower survival rate compared with that in those who underwent examination within 1 year.

Original languageEnglish
Pages (from-to)631-638
Number of pages8
JournalDigestive and Liver Disease
Volume53
Issue number5
DOIs
StatePublished - May 2021

Bibliographical note

Funding Information:
This Research was supported by National Evidence-based Healthcare Collaborating Agency (NECA) funded by the Ministry of Health and welfare (Grant number: NC17-001 ).

Publisher Copyright:
© 2021 Editrice Gastroenterologica Italiana S.r.l.

Keywords

  • Adherence
  • Colonoscopy
  • Colorectal cancer
  • Fecal occult blood test
  • Follow-up

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