Positive Results from the Fecal Immunochemical Test Can Be Related to Dementia: A Nationwide Population-Based Study in South Korea

Article type: Research Article

Authors: Jun, Yu Kyung^{a; b} | Lee, Seung Woo^c | Kim, Kwang Woo^{a; d} | Moon, Jung Min^e | Koh, Seong-Joon^{a; f} | Lee, Hyun Jung^{a; f} | Kim, Joo Sung^{a; f} | Han, Kyungdo^{g; 1; *} | Im, Jong Pil^{a; f; 1; *}

Affiliations: [a] Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea | [b] Department of Internal Medicine, Division of Gastroenterology, Seoul National University Bundang Hospital, Seongnam, Korea | [c] Department of Biomedicine & Health Sciences, College of Medicine, Catholic University of Korea, Seoul, Korea | [d] Department of Internal Medicine, Division of Gastroenterology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea | [e] Department of Internal Medicine, Chung-ang University College of Medicine, Seoul, Korea | [f] Department of Internal Medicine, Division of Gastroenterology, Seoul National University Hospital, Seoul, Korea | [g] Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea

Correspondence: [*] Correspondence to: Jong Pil Im, MD, MPH, PhD, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Tel.: +82 2 740 8446; Fax: +82 2 743 6701; E-mail: [email protected] and Han Kyungdo, MS, Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul 06978, Republic of Korea. Tel.: +82 2 828 7025; Fax: +82 2 823 1746; E-mail: [email protected].

Note: [1] These authors contributed equally to this work and share last authorship.

Abstract: Background:The fecal immunochemical test (FIT) is widely used in screening for colorectal cancer (CRC), but FIT results can be positive for diseases other than CRC. Objective:We investigated the association between positive results of FIT and the incidence of dementia using a nationwide database. Methods:FIT-positive participants were collected from a database provided by the Korean National Health Insurance Service. Results:The incidence of all kinds of dementia was higher in FIT-positive than FIT-negative subjects (p < 0.0001). FIT-positive participants had a higher risk of Alzheimer’s disease (AD) (p < 0.0001) and vascular dementia (p = 0.0002), compared to participants with FIT negativity. The risk of all kinds of dementia or AD in FIT-positive participants was higher in younger (age < 65 years) than older participants (p < 0.0001 for all kinds of dementia; p = 0.0002 for AD). Conclusion:FIT positivity was correlated with an increased risk of dementia, especially in participants under 65 years of age. The study suggests that clinicians can consider dementia when FIT-positive participants fail to show any malignancies.

Keywords: Alzheimer’s disease, dementia, occult blood, population surveillance, vascular dementia

DOI: 10.3233/JAD-220770

Journal: Journal of Alzheimer's Disease, vol. 91, no. 4, pp. 1515-1525, 2023