Effect of aspirin and antiplatelet drugs on the outcome of the fecal immunochemical test.

Abstract:

OBJECTIVE:To evaluate the effect of aspirin and nonaspirin antiplatelet agents (NAAAs) on the performance of the fecal immunochemical test (FIT). PARTICIPANTS AND METHODS:We performed a post hoc analysis of results from a clinical trial that involved 28,696 asymptomatic average-risk men and women aged 50 to 69 years invited to participate in a colorectal cancer screening program with FIT between November 1, 2008, and June 31, 2011. RESULTS:The test was returned by 6390 individuals (22.3%), of whom 5821 (91.1%) reported not using antiplatelet drugs (nonusers group) and 569 (8.9%) reported using these drugs at the time of testing (users group). The FIT result was positive in 48 of 569 users (8.4%) and 365 of 5821 nonusers (6.3%) (P=.05). A positive FIT result was found in 7.3% (28/384) of aspirin users, 7.1% (10/140) of NAAA users, and 22.2% (10/45) of those undergoing dual antiplatelet therapy (DAPT) (aspirin plus an NAAA). The DAPT subgroup had a significantly higher positive FIT rate than the nonuser group (odds ratio, 3.5; 95% CI, 1.7-7.3; P<.05). The positive predictive value (PPV) for advanced neoplasia (AN) in nonusers was 50.4% vs 50.0% in users (P = .40). The PPV for AN was 57.0% in aspirin users, 30.0% in NAAA users, and 50.0% in DAPT users, without statistically significant differences between the user and nonuser groups. CONCLUSION:The use of DAPT increased the rate of positive FIT results. Use of aspirin, NAAAs, or both did not modify the PPV for AN in this population-based colorectal screening program.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Bujanda L,Lanas Á,Quintero E,Castells A,Sarasqueta C,Cubiella J,Hernandez V,Morillas JD,Perez-Fernández T,Salas D,Andreu M,Carballo F,Bessa X,Cosme A,Jover R,COLONPREV Study Investigators.

doi

10.1016/j.mayocp.2013.04.016

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

683-9

issue

7

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(13)00315-7

journal_volume

88

pub_type

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