Cause of Death, Mortality and Occult Blood in Colorectal Cancer Screening

Lasse Kaalby*, Issam Al-Najami, Ulrik Deding, Gabriele Berg-Beckhoff, Robert J.C. Steele, Morten Kobaek-Larsen, Aasma Shaukat, Morten Rasmussen, Gunnar Baatrup


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Fecal hemoglobin (f-Hb) detected by the guaiac fecal occult blood test (gFOBT) may be associated with mortality and cause of death in colorectal cancer (CRC) screening participants. We investigated this association in a randomly selected population of 20,694 participants followed for 33 years. We followed participants from the start of the Hemoccult-II CRC trial in 1985–1986 until December 2018. Data on mortality, cause of death and covariates were retrieved using Danish national registers. We conducted multivariable Cox regressions with time-varying exposure, reporting results as crude and adjusted hazard ratios (aHRs). We identified 1766 patients with at least one positive gFOBT, 946 of whom died in the study period. Most gFOBT-positive participants (93.23%) died of diseases unrelated to CRC and showed higher non-CRC mortality than gFOBT-negative participants (aHR: 1.20, 95% CI 1.10–1.30). Positive gFOBT participants displayed a modest increase in all-cause (aHR: 1.28, 95% CI: 1.18–1.38), CRC (aHR: 4.07, 95% CI: 3.00–5.56), cardiovascular (aHR: 1.22, 95% CI: 1.07–1.39) and endocrine and hematological mortality (aHR: 1.58, 95% CI: 1.19–2.10). In conclusion, we observed an association between positive gFOBT, cause of death and mortality. The presence of f-Hb in the gFOBT might indicate the presence of systemic diseases.

Udgave nummer1
Antal sider11
StatusUdgivet - jan. 2022

Bibliografisk note

Funding Information:
Funding: The Danish Cancer Society (R100-A6747), Odense University Hospital (A3472/A2359), the US Department of Veterans Affairs (36C24E18P0155) and the University of Southern Denmark supported this study.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


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