P-211 Risk of diabetes in subjects with positive fecal immunochemical test: A nationwide population-based study

Abstract

Positive fecal immunochemical test (FIT) results in addition to colorectal cancer (CRC) screening have been recently suggested as a risk factor for systemic inflammation. Diabetes induces inflammation in the gastrointestinal tract, but the etiology is unclear. We investigated the association between FIT results and the incidence of diabetes. A total of 7,946,393 individuals aged ≥ 50 years from the National Cancer Screening Program database who underwent FIT for CRC screening from January, 2009 to December, 2012 were enrolled. The primary outcome was newly diagnosed diabetes based on the International Classification of Disease 10th revision codes and administration of anti-diabetic medication during the follow-up period. During a mean follow-up of 6.5 years, the incidence rates of diabetes were 11.97, 13.60, 14.53, and 16.82 per 1,000 person-years in the FIT negative, one-positive, two-positive, and three-positive groups, respectively. The hazard ratios (HRs) for the incidence of diabetes were 1.14 [95% confidence interval (CI) 1.12–1.16], 1.21; 95% CI 1.16–1.27, and 1.40; 95% CI 1.28–1.55] in the one-positive, two-positive, and three-positive FIT groups compared with the FIT negative group, respectively. The effect was consistent in individuals without dyslipidemia [adjusted hazard ratio (aHR) 1.50 vs. 1.10, p for interaction = 0.002] and those with normal fasting blood glucose (aHR 1.60 vs. 1.12, p for interaction < 0.001). Positive FIT results were associated with a significantly higher risk of diabetes, suggesting that the FIT can play a role not only as a CRC screening tool, but also as a surrogate marker of systemic inflammation; thus, increasing the diabetes risk.