Abstract
Objective
To evaluate the effect of aspirin and nonaspirin antiplatelet agents (NAAAs) on the
performance of the fecal immunochemical test (FIT).
Participants and Methods
We performed a post hoc analysis of results from a clinical trial that involved 28,696
asymptomatic average-risk men and women aged 50 to 69 years invited to participate
in a colorectal cancer screening program with FIT between November 1, 2008, and June
31, 2011.
Results
The test was returned by 6390 individuals (22.3%), of whom 5821 (91.1%) reported not
using antiplatelet drugs (nonusers group) and 569 (8.9%) reported using these drugs
at the time of testing (users group). The FIT result was positive in 48 of 569 users
(8.4%) and 365 of 5821 nonusers (6.3%) (P=.05). A positive FIT result was found in 7.3% (28/384) of aspirin users, 7.1% (10/140)
of NAAA users, and 22.2% (10/45) of those undergoing dual antiplatelet therapy (DAPT)
(aspirin plus an NAAA). The DAPT subgroup had a significantly higher positive FIT
rate than the nonuser group (odds ratio, 3.5; 95% CI, 1.7-7.3; P<.05). The positive predictive value (PPV) for advanced neoplasia (AN) in nonusers
was 50.4% vs 50.0% in users (P = .40). The PPV for AN was 57.0% in aspirin users, 30.0% in NAAA users, and 50.0%
in DAPT users, without statistically significant differences between the user and
nonuser groups.
Conclusion
The use of DAPT increased the rate of positive FIT results. Use of aspirin, NAAAs,
or both did not modify the PPV for AN in this population-based colorectal screening
program.
Trial Registration
clinicaltrials.gov Identifier: NCT00906997
Abbreviations and Acronyms:
AA (advanced adenoma), AN (advanced neoplasia), CRC (colorectal cancer), DAPT (dual antiplatelet therapy), FIT (fecal immunochemical test), NAAA (nonaspirin antiplatelet agent), NAN (nonadvanced neoplasia), PPV (positive predictive value)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 10, 2013
Footnotes
A complete list of the COLONPREV Study Investigators appears in the Supplemental Note (available at http://www.mayoclinicproceedings.org).
Grant Support: This work was supported by grants from the Asociación Española contra el Cáncer (Fundación Científica and Junta de Barcelona) , the Instituto de Salud Carlos III ( PI08/90717 ), and Agència de Gestió d’Ajuts Universitaris i de Recerca ( 2009SGR849 ). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) is funded by Instituto de Salud Carlos III. In the Basque Country, the study received additional support with grants from Obra Social de Kutxa , Diputación Foral de Gipúzkoa (DFG 07/5), Departamento de Sanidad del Gobierno Vasco , EITB-Maratoia (BIO 07/CA/19), and the Acción Transversal contra el Cáncer del CIBERehd (2008). In Galicia, this work was supported by Dirección Xeral de Innovación e Xestión da Saúde Pública , Conselleria de Sanidade, Xunta de Galicia. OC-Micro instruments and fecal immunochemical tests were kindly provided by Eiken Chemical Co Ltd , Japan, and its Spanish representatives, Palex Medical and Biogen; none of them were involved in the design of study or in the analysis or interpretation of results.
Identification
Copyright
© 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
