Fecal occult blood test may improve CRC outcomes in some

(HealthDay)—Fecal occult blood test (FOBT) screening for colorectal cancer (CRC) is associated with several improved outcomes in men but not women, according to a study recently published in the British Journal of Surgery.

Laura Koskenvuo, M.D., Ph.D., from Helsinki University Hospital, and colleagues randomly assigned men and women aged 60 to 69 years to the screening (743 patients) and control arms (617 patients) of the Finnish FOBT program (2004 to 2011).

The researchers found that CRC was less common in women than men (0.34 versus 0.5 percent; risk ratio, 0.82); in addition, women were less frequently asymptomatic (16.7 versus 22 percent; risk ratio, 0.76). Right-sided tumors were more common in women (32 versus 21.3 percent; risk ratio, 1.51). For men with left-sided tumors, compared with the control arm, those in the screening arm had lower N and M categories (risk ratios, 1.23 and 1.57, respectively) and a higher rate of overall survival. In addition, in the control arm, nonradical resections (26.2 versus 15.7 percent; risk ratio, 1.67) and postoperative chemotherapy sessions (61.6 versus 48.2 percent; risk ratio, 1.28) were more frequent among men with left-sided tumors. Men with right-sided tumors and women did not appear to experience the same benefits of FOBT screening.

"The sex discrepancy in outcomes may be due to factors related to the incidence, symptoms, and location of colorectal tumors," the authors write.

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