{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:23:50Z","timestamp":1740126230338,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,12,11]],"date-time":"2019-12-11T00:00:00Z","timestamp":1576022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000950","name":"Cancer Council South Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Fecal immunochemical tests (FIT) are used to screen asymptomatic individuals aged 50\u201374\u00a0years for colorectal cancer (CRC) within the Australian screening program. Gastrointestinal symptoms or iron deficiency anemia (IDA) may also drive primary care physicians to request a FIT. This study aimed to examine factors that may increase neoplasia risk associated with a positive FIT, specifically age, gastrointestinal symptoms, or IDA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective audit was performed on colonoscopies performed in a single hospital in South Australia for a positive FIT (from all referral sources) between 2014 and 2017. Patients aged &lt;\u00a050\u00a0years, or who had a colonoscopy in the preceding 5\u00a0years, were excluded. A subgroup (<jats:italic>n<\/jats:italic>\u00a0=\u00a0198) was evaluated to assess whether age\u00a0\u2265\u00a075\u00a0years, symptoms, or IDA, as well as other demographics, comorbidities, and medications, were associated with risk of neoplasia. Features found to be associated with risk for CRC or high\u2010risk adenoma were examined in the entire cohort using multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Colonoscopies (750\/4221, 17.8%) were completed in patients \u2265\u00a050\u00a0years for a positive FIT. Of these, 7.6% (<jats:italic>n<\/jats:italic>\u00a0=\u00a057) also had gastrointestinal symptoms, 5.5% (<jats:italic>n<\/jats:italic>\u00a0=\u00a041) IDA, and 13.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a098) were \u2265\u00a075\u00a0years. At colonoscopy, 2.8% (<jats:italic>n<\/jats:italic>\u00a0=\u00a021) were diagnosed with CRC and 23.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0174) with high\u2010risk adenoma. CRC was more prevalent in \u2265\u00a075\u00a0years compared with 50\u201374\u00a0years (7.1% <jats:italic>vs<\/jats:italic> 2.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005), and associated with symptoms (15.8% <jats:italic>vs<\/jats:italic> 1.7%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and IDA (14.6% <jats:italic>vs<\/jats:italic> 2.1%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Multivariate analysis showed that IDA (odds ratio 7.68, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and symptoms (odds ratio 10.37, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), but not age, were independent risk factors for CRC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of gastrointestinal symptoms or IDA, independent of age, is associated with an increased risk for CRC following a positive FIT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14888","type":"journal-article","created":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T06:29:17Z","timestamp":1570948157000},"page":"1002-1008","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Older age, symptoms, or anemia: Which factors increase colorectal cancer risk with a positive fecal immunochemical test?"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-8856","authenticated-orcid":false,"given":"Zaki","family":"Hamarneh","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin L","family":"Symonds","sequence":"additional","affiliation":[{"name":"Bowel Health Service Flinders Medical Centre  Adelaide South Australia Australia"},{"name":"Flinders Centre for Innovation in Cancer  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feruza","family":"Kholmurodova","sequence":"additional","affiliation":[{"name":"Flinders Centre for Innovation in Cancer  Adelaide South Australia Australia"},{"name":"Flinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Cock","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,11]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare (AIHW) Australian Cancer Incidence and Mortality (ACIM) books: colorectal (bowel) cancer AIHW Canberra December 2017."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-309086"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2501-6"},{"volume-title":"Clinical practice guidelines for the prevention, early detection and management of colorectal cancer","year":"2017","author":"Cancer Council Australia Colorectal Cancer Guidelines Working Party","key":"e_1_2_6_5_1"},{"key":"e_1_2_6_6_1","unstructured":"Australian Institute of Health and Welfare2019.National Bowel Cancer Screening Program: monitoring report 2019. 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