title: Deprivation and faecal haemoglobin: implications for bowel cancer screening.
abstract: OBJECTIVE
  To investigate the relationship between deprivation and faecal haemoglobin concentration (f-Hb).
  
  
  METHODS
  Scottish Bowel Screening Programme.
  
  
  METHODS
  A total of 66725 men and women, aged 50 to 74, were invited to provide a single sample for a faecal immunochemical test. Deprivation was estimated using the Scottish Index of Multiple Deprivation quintiles: f-Hb was measured (OC-Sensor, Eiken, Japan) on 38439 participants. The relationship between deprivation quintiles and f-Hb was examined.
  
  
  RESULTS
  Median age was 60 years, 53.6% women, with 14.1%, 19.7%, 17.7%, 25.9% and 22.6% in the lowest to the highest deprivation quintiles respectively. No detectable f-Hb was found in 51.9%, ranging from 45.5% in the most deprived up to 56.5% in the least deprived. As deprivation increased, f-Hb increased (p < 0.0001). This trend remained controlling for sex and age (p < 0.001). Participants in the most deprived quintile were more likely to have a f-Hb above a cut-off of 80 µg Hb/g faeces compared with the least deprived, independent of sex and age (adjusted odds ratio 1.70, 95% confidence interval: 1.37 to 2.11).
  
  
  CONCLUSIONS
  Deprivation and f-Hb are related. This has important implications for selection of cut-off f-Hb for screening programmes, and supports the inclusion of deprivation in risk-scoring systems.
authors.affiliation: Scottish Bowel Screening Research Unit, University of Dundee, Dundee, Scotland.
authors.forename: Jayne
authors.initials: J
authors.lastname: Digby
authors.affiliation: Scottish Bowel Screening Centre Laboratory, Kings Cross, Dundee, Scotland.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: McDonald
authors.affiliation: Scottish Bowel Screening Centre Laboratory, Kings Cross, Dundee, Scotland.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Strachan
authors.affiliation: Scottish Bowel Screening Research Unit, University of Dundee, Dundee, Scotland.
authors.forename: Gillian
authors.initials: G
authors.lastname: Libby
authors.affiliation: Medical Research Institute, University of Dundee, Dundee, Scotland.
authors.forename: Robert J C
authors.initials: RJ
authors.lastname: Steele
authors.affiliation: Centre for Research into Cancer Prevention & Screening, University of Dundee, Dundee, Scotland callum.fraser@nhs.net.
authors.forename: Callum G
authors.initials: CG
authors.lastname: Fraser
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005243:Feces / Q000737:chemistry*; D005260:Female; D054625:Healthcare Disparities; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors
chemical_list: D006454:Hemoglobins
keywords: Colorectal cancer; deprivation; faecal haemoglobin; faecal immunochemical test; screening