Evidence map›Paper›PMID 30668711›Full record

ArticleInternational journal of epidemiology2019

Association of ten gastrointestinal and other medical conditions with positivity to faecal occult blood testing in routine screening: a large prospective study of women in England.

Emily He, Rupert Alison, Roger Blanks, Kirstin Pirie, Gillian Reeves, Robyn L Ward, Robert Steele, Julietta Patnick, Karen Canfell, Valerie Beral and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Emily HeCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Rupert AlisonCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Roger BlanksCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Kirstin PirieCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Gillian ReevesCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Robyn L WardFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Robert SteeleDepartment of Surgery, Ninewells Hospital, Dundee, UK.
Julietta PatnickCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Karen CanfellPrince of Wales Clinical School, University of New South Wales Sydney, NSW, Australia.
Valerie BeralCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Jane GreenCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
University of Oxford · GBCancer Council NSW · AUNinewells Hospital · GBUniversity of Sydney · AUUNSW Sydney · AU

Funding

Cancer Research UK 16491Medical Research Council
6 · The paper itself

Abstract

backgroundIn 2006, the Bowel Cancer Screening Programme (BCSP) in England began offering biennial faecal occult blood testing (FOBt) at ages 60-69 years. Although FOBt is aimed at detecting colorectal neoplasms, other conditions can affect the result. In a large UK prospective study, we examined associations, both before and after screening, between FOBt positivity and 10 conditions that are often associated with gastrointestinal bleeding.

methodsBy electronically linking BCSP and Million Women Study records, we identified 604 495 women without previous colorectal cancer who participated in their first routine FOBt screening between 2006 and 2012. Regression models, using linked national hospital admission records, yielded adjusted relative risks (RRs) in FOBt-positive versus FOBt-negative women for colorectal cancer, adenoma, diverticular disease, inflammatory bowel disease, haemorrhoids, upper gastrointestinal cancer, oesophagitis, peptic ulcer, anaemia and other haematological disorders.

resultsRRs in FOBt-positive versus FOBt-negative women were 201.3 (95% CI 173.8-233.2) for colorectal cancer and 197.9 (95% CI 180.6-216.8) for adenoma within 12 months after screening and 3.49 (95% CI 2.31-5.26) and 4.88 (95% CI 3.80-6.26), respectively, 12-24 months after screening; P < 0.001 for all RRs. In the 12 months after screening, the RR for inflammatory bowel disease was 26.3 (95% CI 19.9-34.7), and ranged between 2 and 5 for the upper gastrointestinal or haematological disorders. The RRs of being diagnosed with any of the eight conditions other than colorectal neoplasms before screening, and in the 12-24 months after screening, were 1.81 (95% CI 1.81-2.01) and 1.92 (95% CI 1.66-2.13), respectively.

conclusionsWhereas FOBt positivity is associated with a substantially increased risk of colorectal neoplasms after screening, eight other gastrointestinal and haematological conditions are also associated with FOBt positivity, both before and after screening.

Indexed as

Occult BloodAgedColorectal NeoplasmsEnglandFemaleGastrointestinal HemorrhageHematologic DiseasesHumansInflammatory Bowel DiseasesLogistic ModelsMass ScreeningMiddle AgedProspective StudiesTime Factorsbowel cancerBowel cancer screeningcolonoscopyfaecal occult blood testupper gastrointestinal bleeding

Identifiers

PMID30668711
PMCPMC6469304
OpenAlexW2911663866

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.