PMID- 30169524
OWN - NLM
STAT- MEDLINE
DCOM- 20190211
LR  - 20190215
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 8
DP  - 2018
TI  - Proton pump inhibitors reduce the accuracy of faecal immunochemical test for 
      detecting advanced colorectal neoplasia in symptomatic patients.
PG  - e0203359
LID - 10.1371/journal.pone.0203359 [doi]
LID - e0203359
AB  - BACKGROUND: The faecal immunochemical test (FIT) is used in colorectal cancer 
      (CRC) screening and for the detection of advanced colorectal neoplasia (AN) in 
      symptomatic patients, but its accuracy could be improved. Our objective was to 
      assess the impact of proton pump inhibitors (PPI) on the accuracy of the FIT in 
      the detection of AN, namely advanced colorectal adenoma and CRC. METHODS AND 
      FINDINGS: We performed a prospective study of 1002 individuals referred for a 
      diagnostic colonoscopy at Bellvitge University Hospital from September 2011 
      through to October 2012. An exhaustive interview was performed by a 
      gastroenterologist, prescription drug dispensing database was reviewed and the 
      patient was given a FIT prior to colonoscopy. The positivity threshold of FIT 
      used was >/= 20 mug Hb/g feces and the main outcome was AN. AN was detected in 13.2% 
      (133) of patients. The accuracy of FIT for detecting AN in the PPI users and 
      non-PPI users were: sensitivity 43.0% vs 65.6%, P = 0.009; specificity 86.9% vs 
      92.3%, P = 0.010; and, predictive positive value 34.4% vs 55.5%, P = 0.007, 
      respectively. In multivariate analysis, adjusting for potential confounders, PPIs 
      were associated with false positives in AN detection by FIT (OR 1.63 CI 95% 
      1.02-2.59, P < 0.037). The ROC curve for the FIT in the detection of AN in the 
      PPI users and non-PPI users was 0.68 (CI 95% 0.61-0.76) and 0.85 (CI 95% 
      0.79-0.90). CONCLUSIONS: PPI therapy reduces the accuracy of FIT for detecting AN 
      in symptomatic patients.
FAU - Rodriguez-Alonso, Lorena
AU  - Rodriguez-Alonso L
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Rodriguez-Moranta, Francisco
AU  - Rodriguez-Moranta F
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Arajol, Claudia
AU  - Arajol C
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Gilabert, Pau
AU  - Gilabert P
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Serra, Katja
AU  - Serra K
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Martin, Albert
AU  - Martin A
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
FAU - Ibanez-Sanz, Gemma
AU  - Ibanez-Sanz G
AUID- ORCID: 0000-0001-6071-7343
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
AD  - Catalan Institute of Oncology, Cancer Prevention and Control Programme, IDIBELL, 
      Barcelona, Spain.
FAU - Moreno, Victor
AU  - Moreno V
AD  - Catalan Institute of Oncology, Cancer Prevention and Control Programme, IDIBELL, 
      Barcelona, Spain.
FAU - Guardiola, Jordi
AU  - Guardiola J
AD  - Department of Gastroenterology and Hepatology, University Hospital of 
      Bellvitge-IDIBELL, Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180831
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adenoma/diagnosis
MH  - Colonoscopy/methods
MH  - Colorectal Neoplasms/*diagnosis
MH  - Early Detection of Cancer/methods
MH  - Feces/*chemistry
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*chemistry
MH  - Sensitivity and Specificity
PMC - PMC6118361
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/09/01 06:00
MHDA- 2019/02/12 06:00
PMCR- 2018/08/31
CRDT- 2018/09/01 06:00
PHST- 2017/09/15 00:00 [received]
PHST- 2018/08/20 00:00 [accepted]
PHST- 2018/09/01 06:00 [entrez]
PHST- 2018/09/01 06:00 [pubmed]
PHST- 2019/02/12 06:00 [medline]
PHST- 2018/08/31 00:00 [pmc-release]
AID - PONE-D-17-33683 [pii]
AID - 10.1371/journal.pone.0203359 [doi]
PST - epublish
SO  - PLoS One. 2018 Aug 31;13(8):e0203359. doi: 10.1371/journal.pone.0203359. 
      eCollection 2018.