Influence of age and gender on surveillance for colorectal tumors in low-risk asymptomatic population.
BACKGROUND
We tried to find the possible "downstream" approach for the low-risk asymptomatic population surveillance for colorectal tumors by fecal occult blood test (FOBT) and flexible sigmoidoscopy (FS) with the factors of age and gender.


METHODS
Retrospectively, 2187 asymptomatic low-risk cases received complete FOBT and FS. These cases also received complete colonoscopy (CF) for definite diagnosis and were separated into two groups by age (age < or = 49 vs. age > or = 50 groups) and gender (male and female groups).


RESULTS
The sensitivity and specificity to FOBT and FS were 44% and 98%, and 65% and 100% respectively for all cases. Significant positive FOBT, FS and CF results were noted in the age > or = 50 group (p=0.002, <0.001, <0.001, respectively). Positive FS and CF results were significantly noted in the male group (p=0.012, 0.009, respectively). After combination of age and gender factors, a positive FOBT result was significant in female cases with age > or = 50 years (p =0.006). Positive FS and CF results were significant in male cases with age > or = 50 (both p<0.001).


CONCLUSIONS
In the surveillance of a low-risk asymptomatic population for colorectal tumor, repeated FOBT might be considered in people of age < or = 49 years regardless of gender. In female and age > or = 50 years, FOBT might be considered first and then FS could be performed in positive FOBT cases. In male and age > or = 50 cases, FS was considered first without FOBT for the surveillance.
Chen
Han-Shiang
HS
Department of Surgery, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, ROC. che0391@ms2.hinet.net
Sheen-Chen
Shyr-Ming
SM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012812:Sigmoidoscopy