Thématique :
- Cancer colorectal (CCR)
Originalité :
Solidité :
Doit faire évoluer notre pratique :
Pas encore
Nom du veilleur :
Professeur Thomas APARICIO
Coup de coeur :
  2018 Jul. pii: gutjnl-2018-316483.  
  doi: 10.1136/gutjnl-2018-316483.  
  Occult blood in faeces is associated with all-cause and non-colorectal cancer mortality  
  Libby G, Fraser CG, Carey FA, Brewster DH, Steele RJC  


Objective An association between detectable faecal haemoglobin (f-Hb) and both the risk of death from colorectal cancer (CRC) and all-cause mortality has been reported. We set out to confirm or refute this observation in a UK population and to explore the association between f-Hb, as indicated by a positive guaiac faecal occult blood test (gFOBT) result, and different causes of death.

Design All individuals (134 192) who participated in gFOBT screening in Tayside, Scotland between 29/03/2000 and 29/03/2016 were studied by linking their test result (positive or negative) with mortality data from the National Records of Scotland database and following to 30/03/2016.

Results Those with a positive test result (n=2714) had a higher risk of dying than those with a negative result, from CRC: HR 7.79 (95% CI 6.13 to 9.89), p<0.0001, (adjusted for, gender, age, deprivation quintile and medication that can cause bleeding) and all non-CRC causes: HR 1.58 (95% CI 1.45 to 1.73), p<0·0001.· In addition, f-Hb detectable by gFOBT was significantly associated with increased risk of dying from circulatory disease, respiratory disease, digestive diseases (excluding CRC), neuropsychological disease, blood and endocrine disease and non-CRC.

Conclusion The presence of detectable f-Hb is associated with increased risk of death from a wide range of causes.

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Question posée
La détection d’un saignement occulte est-il associé à d’autres causes de mortalité que par cancer colorectal ?
Question posée

Les résultats de cette étude laissent perplexes et ne peuvent déboucher sur des modifications de pratiques actuellement.