Abstract
Endoscopic and Pathologic Correlation in Patients with Positive Fecal Immunochemical Test Results
Jessica Aubrei T. Pajimna, MD, DPCP, Sarah Jean C. Bellido, MD, FPCP, FPSG, FPSDE, Jessica Aubrei T. Pajimna, MD, DPCP
St. Luke’s Medical Center Quezon City
Significance: Fecal immunochemical testing (FIT) is a screening tool for colorectal cancer(CRC). Likewise, a positive FIT with iron deficiency anemia(IDA) is an indication for endoscopy. However, most patients who subsequently undergo endoscopy have unremarkable results. We reviewed the value of FIT in detecting significant upper and lower gastrointestinal(GI) lesions.
Methodology: This is a single-center retrospective study involving adult patients in St. Luke’s Medical Center - Quezon City(SLMC QC) who underwent colonoscopy with or without esophagogastroduodenoscopy(EGD) due to FIT positive results as CRC screening or work-up for IDA from January 2018 to December 2022. Participants were classified based on the highest-risk pathology.
Results: 148 patients were entered in the study. The PPV of FIT in predicting significant colon and EGD lesions are 19.6% and 53.38%, respectively. Among those without significant lesions on colonoscopy, 55.5% have significant EGD lesions. PPV specific to anemia is 15% for colonoscopy and 68.3% for EGD while PPV specific for CRC screening is 22.7% for colonoscopy and 43.1% for EGD. The most common significant lesions detected on colonoscopy and EGD are >3 tubular adenomas (34.3%) and erosive gastropathy (61%), respectively.
Conclusion: FIT detects more significant upper than lower GI lesions. However, the fact that we were able to diagnose several colon cancers confirms that FIT is an effective screening tool for CRC. Our study suggests that a concomitant EGD in addition to a colonoscopy in both anemic and non-anemic FIT positive individuals allows for the detection of lesions that may have a significant impact in patient management.
Keywords: retrospective, Fecal Immunochemical Testing, Iron Deficiency Anemia, Screening, Colonoscopy, Esophagogastroduodenoscopy
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |