Prevalence of colorectal malignant and pre-malignant diseases in faecal immunochemical test positive individuals: an observational study

Muhammad Ali Siddiquee; M. Shahidul Islam; Mir Rasekh Alam Ovi; Muhammed Tanvir Jalal; Mohammad Azim Uddin; Kalyan Kumar Saha; Shamima Nasrin; M. Sumon Ali; Joynab Akter

doi:10.18203/2349-2902.isj20250136

Authors

Muhammad Ali Siddiquee Department of Colorectal Surgery, BSMMU, Dhaka, Bangladesh
M. Shahidul Islam Department of Colorectal Surgery, BSMMU, Dhaka, Bangladesh
Mir Rasekh Alam Ovi Department of Surgery, BSMMU, Dhaka, Bangladesh https://orcid.org/0009-0002-9513-2227
Muhammed Tanvir Jalal Department of Colorectal Surgery, BSMMU, Dhaka, Bangladesh
Mohammad Azim Uddin Department of Surgery, MMCH, Dhaka, Bangladesh
Kalyan Kumar Saha Department of Surgery, BSMMU, Dhaka, Bangladesh
Shamima Nasrin Department of Surgery, AKMMC, Dhaka, Bangladesh
M. Sumon Ali Department of Colorectal Surgery, BSMMU, Dhaka, Bangladesh
Joynab Akter Department of Colorectal Surgery, BSMMU, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20250136

Keywords:

Colorectal cancer, Faecal immunochemical test, Guaiac faecal occult blood test

Abstract

Background: Colorectal cancer (CRC) is a challenging clinical entity worldwide. Adenomatous polyps are considered precursors to cancer. For early detection of polyps or ulcers, different screening investigations like colonoscopy, faecal immunochemical test (FIT), gFOBT, CT colonography etc. are used. Despite colonoscopy is being a highly accurate and gold standard therapeutic, it is not easily available in remote areas. The FIT, one of several tests available for CRC screening, is currently used in many countries and well accepted to all patients.

Methods: To find out the prevalence of colorectal malignant and pre-malignant diseases in FIT positive individuals. This prospective cross-sectional observational study was done in the department of colorectal surgery, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka. A total 140 patients were selected according to the inclusion and exclusion criteria. FIT was done who matched. Colonoscopy was done in the FIT positive individuals.

Results: The study patients were aged ≥45 years, with a mean age of 51.73±7.97 years. The most common clinical finding was abdominal pain (n=117), followed mucous discharge (n=56) and changes in bowel habit (n=47). Colonoscopy revealed that 50% of the patients had polyps, 10.71% had nonspecific ulcers, 2.86% had growths, and 12.14% had haemorrhoids. Histopathology showed that 61.43% of the polyps were hyperplastic polyps, and 63.16% of the ulcers were non-specific colitis. Most of the patients had single polyps in colonoscopy. Sensitivity, specificity and PPV of FIT is 85.7%, 97.5% and 66.4% respectively.

Conclusions: The consistent evidence linking FIT positivity to the presence of colorectal malignant and pre-malignant diseases reinforces its efficacy as a frontline screening tool.

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