A population-based study on time trends of hemoglobin in primary care comparing prediagnostic colorectal cancer patients vs age- and sex-matched controls

Li, Mei; Cao, Yang; Olsson, Louise

doi:10.1080/00365521.2021.1879245

Cited by 4 publications

(3 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another study observed a significant correlation between very advanced CRC, compared with locally advanced, in terms of anemia, tumor size and presentation of any symptoms before diagnosis [63]. The study by Li et al consolidates the usefulness of time trends in Hb prior to diagnosis in CRC and questions whether the use of these algorithms could influence the distribution of CRC stages [59]. All these studies have compared patients with CRC and controls without this pathology.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we found that a higher anemia prevalence of up to 71.1% was observed in the CRLM group compared to 52.8% in the CRC group in the three months prior to CRC diagnosis (Table 1). The etiology of anemia is diverse, and its Positive Predictive Value (PPV) for CRC in primary care is only 1-2% [58,59]. In addition, even though 60% of patients with iron deficiency anemia do not have a related cause, endoscopic exploration would be justified as they are at higher risk of suffering CRC [60].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

Sala,

Ery,

Cuesta-Peredo

et al. 2023

JCM

View full text Add to dashboard Cite

Background and Aims: Colorectal cancer (CRC) represents 10% of all cancers worldwide with the highest incidence in developed countries; its incidence is also increasing in middle- and low-income countries. Population screening programs facilitate early diagnosis of the disease. When the diagnosis is carried out in advanced stages, approximately 80% of patients with liver metastases (LM) are considered unresectable at the time of diagnosis. In our study, variations in blood counts prior to CRC diagnosis were analyzed to assess whether they could be useful in identifying smaller, more manageable metastases at earlier stages for more effective treatment. Methods: A study was carried out using complete blood counts (CBCs) from CRC patients, obtained from primary health centers and the La Ribera University Hospital within La Ribera Health Department, Valencian Community, Spain, between July 2012 and September 2020. Data from CRC patients who presented synchronous liver metastasis (CRLM) were compared with those with CRC without LM at diagnosis (CRC patients). Results: Our analysis shows that at least 15 months before CRC diagnosis, a progressive alteration was observed in CBC parameters in both groups. A higher incidence of anemia (p < 0.001) was observed among CRLM patients in the three months prior to CRC diagnosis than in CRC patients showing no LM. Conclusions: A statistically significant deterioration of CBC was observed in patients with advanced-stage CRC and synchronous or early LM (CRLM) in the three months prior to diagnosis. The primary goal of incorporating CBC variations into predictive models is to identify individuals who are at a greater risk of developing metastatic colon cancer, leading to early diagnosis. Our research improves these models by highlighting a more pronounced and rapid decline in hemoglobin levels among CRLM patients. Identification of metastases at an earlier stage when they are smaller, more manageable, and more amenable to treatment may be a valuable tool to prevent their further progression.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

Sala,

Ery,

Cuesta-Peredo

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…For this reason, it is possible that FIT should not be used in symptomatic patients with anaemia, in order to avoid false-negative outcomes. This is a key aspect of a potential use of FIT amongst symptomatic patients as approximately some 40% of CRC patients overall are expected to be anaemic at the time of diagnosis [ 16 , 17 ]. Thorough knowledge on the accuracy of FIT, specifically in patients with either anaemia or amongst those who report rectal bleeding, is a decisive aspect on the potential use of FIT in symptomatic patients, in particular for symptomatic patients presenting in primary care.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background There is increasing evidence supporting the use of faecal immunochemical tests (FIT) in patients reporting symptoms associated with colorectal cancer (CRC), but most studies until now have focused on selected subjects already referred for investigation. We therefore set out to determine the accuracy and predictive values of FIT in a primary care population. Method A prospective, multicentre, single-gated comparative diagnostic study on quantitative FIT in patients aged 40 years and above presenting in primary care with symptoms associated with CRC will be conducted. Patients representing the whole spectrum of severity of such symptoms met with in primary care will be eligible and identified by GPs. Participants will answer a short form on symptoms during the last month. They will provide two faecal samples from two separate days. Analyses will be performed within 5 days (QuikRead go®, Aidian Oy). The analytical working range is 10–200 μg Hb/g faeces. Reference test will be linked to the Swedish Colorectal Cancer Registry up to 2 years after inclusion. Accuracy, area under ROC curves, and predictive values will be calculated for one FIT compared to the highest value of two FIT and at cutoff < 10, 10–14.9, 15–19.9 and ≥ 20 μg Hb/g faeces. Subgroup analyses will be conducted for patients with anaemia and those reporting rectal bleeding. A model-based cost-effectiveness analysis based on the clinical accuracy study will be performed. Based on previous literature, we hypothesized that the sensitivity of the highest value of two FIT at cutoff 10 μg Hb/g faeces will be 95% (95% CI + / − 15%). The prevalence of CRC in the study population was estimated to be 2%, and the rate of non-responders to be 1/6. In all, 3000 patients will be invited at 30 primary care centres. Discussion This study will generate important clinical real-life structured data on accuracy and predictive values of FIT in the most critical population for work-up of CRC, i.e. patients presenting with at times ambiguous symptoms in primary care. It will help establish the role of FIT in this large group. Trial registration NCT05156307. Registered on 14 December 2021—retrospectively registered.

show abstract

Masked anemia and hematocrit elevation under sodium glucose transporter inhibitors: findings from a large real-world study

Schwarz,

Klein,

Lev-Shalem

2023

Acta Diabetol

View full text Add to dashboard Cite

A population-based study on time trends of hemoglobin in primary care comparing prediagnostic colorectal cancer patients vs age- and sex-matched controls

Abstract: Olsson (2021): A population-based study on time trends of hemoglobin in primary care comparing prediagnostic colorectal cancer patients vs age-and sex-matched controls, Scandinavian Journal of Gastroenterology,

Cited by 4 publications

References 18 publications

Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases

Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol

Masked anemia and hematocrit elevation under sodium glucose transporter inhibitors: findings from a large real-world study

Contact Info

Product

Resources

About