title: Impact of faecal haemoglobin concentration on colorectal cancer mortality and all-cause death.
abstract: OBJECTIVE
  To assess the effect of an incremental increase in faecal haemoglobin (f-Hb) concentration on colorectal cancer (CRC) mortality and all-cause death.
  
  
  METHODS
  We conducted an observational study of cohorts over time based on two population-based CRC screening programmes.
  
  
  METHODS
  Two cities of Taiwan.
  
  
  METHODS
  1233 individuals with CRC (217 prevalent cases and 1016 incident cases) and 2640 with colorectal adenoma (1246 prevalent cases and 1394 incident cases) found in the two cohorts of 59 767 and 125 976 apparently healthy individuals, aged 40 years and above, who had been invited to participate in screening since 2001 and 2003, respectively.
  
  
  METHODS
  Death from CRC and all-cause death ascertained by following up from the entire two cohorts over time until 2009.
  
  
  RESULTS
  The effect of an incremental increase in f-Hb on the risk for CRC mortality was noted, increasing from a slightly increased risk for the category of f-Hb of 20-49 ng Hb/mL (adjusted HR (aHR)=1.09; 95% CI 0.68 to 1.75) to 11.67 (95% CI 7.71 to 17.66) for the group with f-Hb≥450 ng Hb/mL as compared with the group considered baseline with f-Hb of 1-19 ng Hb/mL (p<0.001). A similar but less marked increasing trend was found for all-cause mortality, aHR increasing from 1.15 (95% CI 1.07 to 1.24) for the group with f-Hb of 20-49 ng Hb/mL to 1.67 (95% CI 1.54 to 2.07) for the group with f-Hb≥450 ng Hb/mL.
  
  
  CONCLUSIONS
  We substantiated the impacts of an incremental increase in f-Hb on the risk for death from CRC and all-cause death, consistently showing a significant gradient relationship. Both discoveries suggest that f-Hb may not only make contribution to facilitating individually tailored screening for CRC but also can be used as a significant predictor for life expectancy.
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Li-Sheng
authors.initials: LS
authors.lastname: Chen
authors.forename: Amy Ming-Fang
authors.initials: AM
authors.lastname: Yen
authors.forename: Callum G
authors.initials: CG
authors.lastname: Fraser
authors.forename: Sherry Yueh-Hsia
authors.initials: SY
authors.lastname: Chiu
authors.forename: Jean Ching-Yuan
authors.initials: JC
authors.lastname: Fann
authors.forename: Po-En
authors.initials: PE
authors.lastname: Wang
authors.forename: Sheng-Che
authors.initials: SC
authors.lastname: Lin
authors.forename: Chao-Sheng
authors.initials: CS
authors.lastname: Liao
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Lee
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Chiu
authors.forename: Hsiu-Hsi
authors.initials: HH
authors.lastname: Chen
keywords: EPIDEMIOLOGY; PUBLIC HEALTH