title: Characteristics of adenomas detected by fecal immunochemical test in colorectal cancer screening.
abstract: BACKGROUND
  Fecal immunochemical test (FIT) diagnostic accuracy for colorectal adenoma detection in colorectal cancer screening is limited.
  
  
  METHODS
  We analyzed 474 asymptomatic subjects with adenomas detected on colonoscopy in two blinded diagnostic tests studies designed to assess FIT diagnostic accuracy. We determined the characteristics of adenomas (number, size, histology, morphology, and location) and the risk of metachronous lesions (according to European guidelines). Finally, we performed a logistic regression to identify those variables independently associated with a positive result.
  
  
  RESULTS
  Advanced adenomas were found in 145 patients (75.6% distal and 24.3% only proximal to splenic flexure). Patients were classified as low (59.5%), intermediate (30.2%), and high risk (10.3%) according to European guidelines. At a 100-ng/mL threshold, FIT was positive in 61 patients (12.8%). Patients with advanced adenomas [odds ratio (OR), 8.8; 95% confidence interval (CI), 4.76-16.25], distal advanced adenomas (OR, 6.7; 95% CI, 1.9-8.8), high risk (OR, 20.1; 95% CI, 8.8-45.8), or intermediate risk lesions (OR, 6; 95% CI, 2.9-12.4) had more probabilities to have a positive test. The characteristics of adenomas independently associated were number of adenomas (OR, 1.22; 95% CI, 1.04-1.42), distal flat adenomas (OR, 0.44; 95% CI, 0.21-0.96), pedunculated adenomas (OR, 2.28; 95% CI, 1.48-3.5), and maximum size of distal adenomas (mm; OR, 1.24; 95% CI, 1.16-1.32).
  
  
  CONCLUSIONS
  European guidelines classification and adenoma location correlates with the likelihood of a positive FIT result.
  
  
  CONCLUSIONS
  This information allows us to understand the FIT impact in colorectal cancer prevention. Likewise, it should be taken into account in the development of new colorectal adenomas biomarkers.
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain. joaquin.cubiella.fernandez@sergas.es.
authors: Joaquín
authors: J
authors: Cubiella
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Inés
authors: I
authors: Castro
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: Vicent
authors: V
authors: Hernandez
authors: "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain. Department of Clinical Analysis, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
authors: Carmen
authors: C
authors: González-Mao
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Concepción
authors: C
authors: Rivera
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
authors: Felipe
authors: F
authors: Iglesias
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: Lucía
authors: L
authors: Cid
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Santiago
authors: S
authors: Soto
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: Luisa
authors: L
authors: de-Castro
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Pablo
authors: P
authors: Vega
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
authors: Jose Antonio
authors: JA
authors: Hermo
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Ramiro
authors: R
authors: Macenlle
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: Alfonso
authors: A
authors: Martínez
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: David
authors: D
authors: Martínez-Ares
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. "IBIV" Institute of Biomedical Research of Vigo, Vigo, Spain.
authors: Pamela
authors: P
authors: Estevez
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Estela
authors: E
authors: Cid
authors: Donostia Hospital, Biodonostia Institute, University of the Basque Country UPV/EHU, CIBERehd, San Sebastian, Spain.
authors: Marta
authors: M
authors: Herreros-Villanueva
authors: Programa de Cribado de Cáncer Colorrectal, Servicio Vasco de Salud, País Vasco, Spain.
authors: Isabel
authors: I
authors: Portillo
authors: Donostia Hospital, Biodonostia Institute, University of the Basque Country UPV/EHU, CIBERehd, San Sebastian, Spain.
authors: Luis
authors: L
authors: Bujanda
authors: Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors: Javier
authors: J
authors: Fernández-Seara
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000473:pathology; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies; D012307:Risk Factors