A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia

Amy Ming Fang Yen, Sam Li Sheng Chen, Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, Po En Wang, Sheng Che Lin, Yao Der Chen, Chao Sheng Liao, Yen Po Yeh, Yi Chia Lee, Han Mo Chiu, Hsiu His Chen

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

We sought to assess how much of the variation in incidence of colorectal neoplasia is explained by baseline fecal hemoglobin concentration (FHbC) and also to assess the additional predictive value of conventional risk factors. We enrolled subjects aged 40 years and over who attended screening for colorectal cancer with the fecal immunochemical test (FIT) in Keelung community-based integrated screening program. The accelerated failure time model was used to train the clinical weights of covariates in the prediction model. Datasets from two external communities were used for external validation. The area under curve (AUC) for the model containing only FHbC was 83.0% (95% CI: 81.5-84.4%), which was considerably greater than the one containing only conventional risk factors (65.8%, 95% CI: 64.2-67.4%). Adding conventional risk factors did not make significant additional contribution (p = 0.62, AUC = 83.5%, 95% CI: 82.1-84.9%) to the predictive model with FHbC only. Males showed a stronger linear dose-response relationship than females, yielding gender-specific FHbC predictive models. External validation confirms these results. The high predictive ability supported by a dose-dependent relationship between baseline FHbC and the risk of developing colorectal neoplasia suggests that FHbC may be useful for identifying cases requiring closer postdiagnosis clinical surveillance as well as being an early indicator of colorectal neoplasia risk in the general population. Our findings may also make contribution to the development of the FHbC-guided screening policy but its pros and cons in connection with cost and effectiveness of screening should be evaluated before it can be applied to population-based screening for colorectal cancer. What's new? Currently, the fecal immunochemical test is widely used for population screening for colorectal cancer. Could testing for a different protein improve predictive ability? In this paper, the authors evaluated the usefulness of quantifying fecal hemoglobin. They showed that the higher the concentration of fecal hemoglobin, the higher the risk of developing cancer. Thus, this test may help identify patients who need further interventions, if it proves cost-effective and practical to administer.

Original languageEnglish
Pages (from-to)1203-1212
Number of pages10
JournalInternational Journal of Cancer
Volume135
Issue number5
DOIs
Publication statusPublished - Sep 1 2014

Fingerprint

Hemoglobins
Neoplasms
Colorectal Neoplasms
Area Under Curve
Population
Cost-Benefit Analysis
Weights and Measures
Costs and Cost Analysis
Incidence
Proteins

Keywords

  • accelerated failure time model
  • adenoma
  • colorectal cancer
  • fecal hemoglobin concentration
  • predictive model

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia. / Yen, Amy Ming Fang; Chen, Sam Li Sheng; Chiu, Sherry Yueh Hsia; Fann, Jean Ching Yuan; Wang, Po En; Lin, Sheng Che; Chen, Yao Der; Liao, Chao Sheng; Yeh, Yen Po; Lee, Yi Chia; Chiu, Han Mo; Chen, Hsiu His.

In: International Journal of Cancer, Vol. 135, No. 5, 01.09.2014, p. 1203-1212.

Research output: Contribution to journalArticle

Yen, AMF, Chen, SLS, Chiu, SYH, Fann, JCY, Wang, PE, Lin, SC, Chen, YD, Liao, CS, Yeh, YP, Lee, YC, Chiu, HM & Chen, HH 2014, 'A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia', International Journal of Cancer, vol. 135, no. 5, pp. 1203-1212. https://doi.org/10.1002/ijc.28748
Yen, Amy Ming Fang ; Chen, Sam Li Sheng ; Chiu, Sherry Yueh Hsia ; Fann, Jean Ching Yuan ; Wang, Po En ; Lin, Sheng Che ; Chen, Yao Der ; Liao, Chao Sheng ; Yeh, Yen Po ; Lee, Yi Chia ; Chiu, Han Mo ; Chen, Hsiu His. / A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia. In: International Journal of Cancer. 2014 ; Vol. 135, No. 5. pp. 1203-1212.
@article{429c4cf91a37496493d9a120ee524f0f,
title = "A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia",
abstract = "We sought to assess how much of the variation in incidence of colorectal neoplasia is explained by baseline fecal hemoglobin concentration (FHbC) and also to assess the additional predictive value of conventional risk factors. We enrolled subjects aged 40 years and over who attended screening for colorectal cancer with the fecal immunochemical test (FIT) in Keelung community-based integrated screening program. The accelerated failure time model was used to train the clinical weights of covariates in the prediction model. Datasets from two external communities were used for external validation. The area under curve (AUC) for the model containing only FHbC was 83.0{\%} (95{\%} CI: 81.5-84.4{\%}), which was considerably greater than the one containing only conventional risk factors (65.8{\%}, 95{\%} CI: 64.2-67.4{\%}). Adding conventional risk factors did not make significant additional contribution (p = 0.62, AUC = 83.5{\%}, 95{\%} CI: 82.1-84.9{\%}) to the predictive model with FHbC only. Males showed a stronger linear dose-response relationship than females, yielding gender-specific FHbC predictive models. External validation confirms these results. The high predictive ability supported by a dose-dependent relationship between baseline FHbC and the risk of developing colorectal neoplasia suggests that FHbC may be useful for identifying cases requiring closer postdiagnosis clinical surveillance as well as being an early indicator of colorectal neoplasia risk in the general population. Our findings may also make contribution to the development of the FHbC-guided screening policy but its pros and cons in connection with cost and effectiveness of screening should be evaluated before it can be applied to population-based screening for colorectal cancer. What's new? Currently, the fecal immunochemical test is widely used for population screening for colorectal cancer. Could testing for a different protein improve predictive ability? In this paper, the authors evaluated the usefulness of quantifying fecal hemoglobin. They showed that the higher the concentration of fecal hemoglobin, the higher the risk of developing cancer. Thus, this test may help identify patients who need further interventions, if it proves cost-effective and practical to administer.",
keywords = "accelerated failure time model, adenoma, colorectal cancer, fecal hemoglobin concentration, predictive model",
author = "Yen, {Amy Ming Fang} and Chen, {Sam Li Sheng} and Chiu, {Sherry Yueh Hsia} and Fann, {Jean Ching Yuan} and Wang, {Po En} and Lin, {Sheng Che} and Chen, {Yao Der} and Liao, {Chao Sheng} and Yeh, {Yen Po} and Lee, {Yi Chia} and Chiu, {Han Mo} and Chen, {Hsiu His}",
year = "2014",
month = "9",
day = "1",
doi = "10.1002/ijc.28748",
language = "English",
volume = "135",
pages = "1203--1212",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "5",

}

TY - JOUR

T1 - A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia

AU - Yen, Amy Ming Fang

AU - Chen, Sam Li Sheng

AU - Chiu, Sherry Yueh Hsia

AU - Fann, Jean Ching Yuan

AU - Wang, Po En

AU - Lin, Sheng Che

AU - Chen, Yao Der

AU - Liao, Chao Sheng

AU - Yeh, Yen Po

AU - Lee, Yi Chia

AU - Chiu, Han Mo

AU - Chen, Hsiu His

PY - 2014/9/1

Y1 - 2014/9/1

N2 - We sought to assess how much of the variation in incidence of colorectal neoplasia is explained by baseline fecal hemoglobin concentration (FHbC) and also to assess the additional predictive value of conventional risk factors. We enrolled subjects aged 40 years and over who attended screening for colorectal cancer with the fecal immunochemical test (FIT) in Keelung community-based integrated screening program. The accelerated failure time model was used to train the clinical weights of covariates in the prediction model. Datasets from two external communities were used for external validation. The area under curve (AUC) for the model containing only FHbC was 83.0% (95% CI: 81.5-84.4%), which was considerably greater than the one containing only conventional risk factors (65.8%, 95% CI: 64.2-67.4%). Adding conventional risk factors did not make significant additional contribution (p = 0.62, AUC = 83.5%, 95% CI: 82.1-84.9%) to the predictive model with FHbC only. Males showed a stronger linear dose-response relationship than females, yielding gender-specific FHbC predictive models. External validation confirms these results. The high predictive ability supported by a dose-dependent relationship between baseline FHbC and the risk of developing colorectal neoplasia suggests that FHbC may be useful for identifying cases requiring closer postdiagnosis clinical surveillance as well as being an early indicator of colorectal neoplasia risk in the general population. Our findings may also make contribution to the development of the FHbC-guided screening policy but its pros and cons in connection with cost and effectiveness of screening should be evaluated before it can be applied to population-based screening for colorectal cancer. What's new? Currently, the fecal immunochemical test is widely used for population screening for colorectal cancer. Could testing for a different protein improve predictive ability? In this paper, the authors evaluated the usefulness of quantifying fecal hemoglobin. They showed that the higher the concentration of fecal hemoglobin, the higher the risk of developing cancer. Thus, this test may help identify patients who need further interventions, if it proves cost-effective and practical to administer.

AB - We sought to assess how much of the variation in incidence of colorectal neoplasia is explained by baseline fecal hemoglobin concentration (FHbC) and also to assess the additional predictive value of conventional risk factors. We enrolled subjects aged 40 years and over who attended screening for colorectal cancer with the fecal immunochemical test (FIT) in Keelung community-based integrated screening program. The accelerated failure time model was used to train the clinical weights of covariates in the prediction model. Datasets from two external communities were used for external validation. The area under curve (AUC) for the model containing only FHbC was 83.0% (95% CI: 81.5-84.4%), which was considerably greater than the one containing only conventional risk factors (65.8%, 95% CI: 64.2-67.4%). Adding conventional risk factors did not make significant additional contribution (p = 0.62, AUC = 83.5%, 95% CI: 82.1-84.9%) to the predictive model with FHbC only. Males showed a stronger linear dose-response relationship than females, yielding gender-specific FHbC predictive models. External validation confirms these results. The high predictive ability supported by a dose-dependent relationship between baseline FHbC and the risk of developing colorectal neoplasia suggests that FHbC may be useful for identifying cases requiring closer postdiagnosis clinical surveillance as well as being an early indicator of colorectal neoplasia risk in the general population. Our findings may also make contribution to the development of the FHbC-guided screening policy but its pros and cons in connection with cost and effectiveness of screening should be evaluated before it can be applied to population-based screening for colorectal cancer. What's new? Currently, the fecal immunochemical test is widely used for population screening for colorectal cancer. Could testing for a different protein improve predictive ability? In this paper, the authors evaluated the usefulness of quantifying fecal hemoglobin. They showed that the higher the concentration of fecal hemoglobin, the higher the risk of developing cancer. Thus, this test may help identify patients who need further interventions, if it proves cost-effective and practical to administer.

KW - accelerated failure time model

KW - adenoma

KW - colorectal cancer

KW - fecal hemoglobin concentration

KW - predictive model

UR - http://www.scopus.com/inward/record.url?scp=84902540129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902540129&partnerID=8YFLogxK

U2 - 10.1002/ijc.28748

DO - 10.1002/ijc.28748

M3 - Article

C2 - 24482014

AN - SCOPUS:84902540129

VL - 135

SP - 1203

EP - 1212

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 5

ER -