ArticleJournal of the anus, rectum and colon2026
Propensity Score-matched Analysis of the Impact of Direct-acting Oral Anticoagulants on Fecal Immunochemical Test Performance.
Article in Journal of the anus, rectum and colon, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
12 authors.
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Abstract
Objectives: The fecal immunochemical test (FIT) is widely used for colorectal cancer (CRC) screening, owing to its high diagnostic accuracy. Antithrombotic medications, particularly direct-acting oral anticoagulants (DOACs), can influence FIT performance; however, the evidence concerning this phenomenon remains inconsistent in the literature. This study evaluated the impact of DOACs on the positive predictive value (PPV) of FIT for diagnosing advanced neoplasia (AN). Methods: This retrospective study, conducted at Mie University Hospital, analyzed 818 patients who underwent colonoscopy procedures following positive FIT results between 2015 and 2024. A propensity score-matched analysis was used to compare PPVs for AN, advanced adenoma, invasive cancer, and all adenomas in the patients who did and did not use DOAC. A logistic regression model was used to conduct a sensitivity analysis evaluating the associations between DOAC use and FIT performance. Results: AN was diagnosed in 4.0% of the DOAC users and 16.8% of the non-users. Our propensity score-matched analysis confirmed that the PPV for AN in the DOAC-user group was significantly lower than that in the non-user group (odds ratio 0.20, 95% confidence interval 0.05-0.92, Conclusions: DOAC use significantly reduced the PPV of FIT for diagnosing AN. This finding suggests that current guidelines should consider alternative strategies, such as adjunctive diagnostic tools, to improve accuracy and reduce unnecessary colonoscopies in patients using DOACs.
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