PMID- 33159805 OWN - NLM STAT- MEDLINE DCOM- 20211129 LR - 20211129 IS - 1435-5922 (Electronic) IS - 0944-1174 (Linking) VI - 56 IP - 1 DP - 2021 Jan TI - Proton-pump inhibitors are associated with a high false-positivity rate in faecal immunochemical testing. PG - 42-53 LID - 10.1007/s00535-020-01738-z [doi] AB - BACKGROUND: False-positivity rates in faecal immunochemical test (FIT) can be affected by drug exposure. We aimed to assess the association between proton pump inhibitors (PPI) consumption and false positive (FP) results in a colorectal cancer (CRC) screening programme using electronic prescription records. METHODS: A retrospective cohort study within a population-based screening program for CRC from 2010 to 2016 was performed. Participants with a conclusive FIT result and with prescription electronic data were included. An FP result was defined as having a positive FIT (>/= 20 microg haemoglobin/g faeces) and a follow-up colonoscopy without intermediate or high-risk lesions or CRC. Screening data were anonymously linked to the public data analysis program for health research and innovation (PADRIS) database that recorded patient diseases history and reimbursed medication. PPI exposure was defined as having retrieved at least one dispensation of PPI three months prior to the FIT. RESULTS: A total of 89,199 tests (of 46,783 participants) were analysed, 4824 (5.4%) tested positive and the proportion of FP was 53.5%. Overall, 17,544 participants (19.7%) were PPI users prior to FIT performance. PPI exposure increased the probability of obtaining an FP FIT result from 50.4 to 63.3% (adjusted OR 1.39; 95% CI 1.18-1.65). Nonsteroidal anti-inflammatory drugs, acetylsalicylic acid, antibiotics, and laxatives were also associated with an FP result. The effect of PPI was independent and showed a synergistic interaction with nonsteroidal anti-inflammatory drugs. CONCLUSION: PPIs increase FIT positivity at the expense of FP results. The recommendation to avoid their use before FIT performance could reduce up to 3% of colonoscopies and 9% of FP results. FAU - Ibanez-Sanz, Gemma AU - Ibanez-Sanz G AD - Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology, Avinguda Gran Via, 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Gastroenterology Department, Bellvitge University Hospital, Carrer Feixa Llarga s/n., 08908, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Colorectal Cancer Research Group, ONCOBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. AD - CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. FAU - Mila, Nuria AU - Mila N AD - Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Early Detection of Cancer Research Group, EPIBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. FAU - de la Pena-Negro, Luisa C AU - de la Pena-Negro LC AD - Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology, Avinguda Gran Via, 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Gastroenterology Department, Bellvitge University Hospital, Carrer Feixa Llarga s/n., 08908, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Gastroenterology Department, Viladecans Hospital, Viladecans, Spain. FAU - Garcia, Montse AU - Garcia M AD - CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. AD - Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Early Detection of Cancer Research Group, EPIBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. FAU - Vidal, Carmen AU - Vidal C AD - Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Early Detection of Cancer Research Group, EPIBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. FAU - Rodriguez-Alonso, Lorena AU - Rodriguez-Alonso L AD - Gastroenterology Department, Bellvitge University Hospital, Carrer Feixa Llarga s/n., 08908, L'Hospitalet de Llobregat, Barcelona, Spain. FAU - Binefa, Gemma AU - Binefa G AD - CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. AD - Cancer Screening Unit, Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. AD - Early Detection of Cancer Research Group, EPIBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. FAU - Rodriguez-Moranta, Francisco AU - Rodriguez-Moranta F AD - Gastroenterology Department, Bellvitge University Hospital, Carrer Feixa Llarga s/n., 08908, L'Hospitalet de Llobregat, Barcelona, Spain. frmoranta@bellvitgehospital.cat. AD - CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. frmoranta@bellvitgehospital.cat. FAU - Moreno, Victor AU - Moreno V AUID- ORCID: 0000-0002-2818-5487 AD - Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology, Avinguda Gran Via, 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain. v.moreno@iconcologia.net. AD - Colorectal Cancer Research Group, ONCOBELL Program, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. v.moreno@iconcologia.net. AD - CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. v.moreno@iconcologia.net. AD - Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. v.moreno@iconcologia.net. LA - eng GR - (PI12/00992/Instituto de Salud Carlos III/ GR - PI14-00613/Instituto de Salud Carlos III/ GR - PI16/00588/Instituto de Salud Carlos III/ GR - 2017 SGR 723/Departament d'Innovacio, Universitats i Empresa, Generalitat de Catalunya/ GR - 2017 SGR 1283/Departament d'Innovacio, Universitats i Empresa, Generalitat de Catalunya/ PT - Journal Article PT - Validation Study DEP - 20201107 PL - Japan TA - J Gastroenterol JT - Journal of gastroenterology JID - 9430794 RN - 0 (Proton Pump Inhibitors) SB - IM MH - Adenoma/*diagnosis MH - Aged MH - Carcinoma/*diagnosis MH - Colonoscopy MH - Colorectal Neoplasms/*diagnosis MH - Early Detection of Cancer/*methods MH - False Positive Reactions MH - Female MH - Follow-Up Studies MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - *Occult Blood MH - Odds Ratio MH - *Proton Pump Inhibitors MH - Retrospective Studies MH - Unnecessary Procedures OTO - NOTNLM OT - Colorectal cancer screening OT - Faecal immunochemical test OT - False positive OT - Nonsteroidal anti-inflammatory drugs OT - Proton pump inhibitors EDAT- 2020/11/08 06:00 MHDA- 2021/11/30 06:00 CRDT- 2020/11/07 17:05 PHST- 2020/01/15 00:00 [received] PHST- 2020/10/11 00:00 [accepted] PHST- 2020/11/08 06:00 [pubmed] PHST- 2021/11/30 06:00 [medline] PHST- 2020/11/07 17:05 [entrez] AID - 10.1007/s00535-020-01738-z [pii] AID - 10.1007/s00535-020-01738-z [doi] PST - ppublish SO - J Gastroenterol. 2021 Jan;56(1):42-53. doi: 10.1007/s00535-020-01738-z. Epub 2020 Nov 7.