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Association between faecal occult bleeding and medicines prescribed for chronic disease: a data linkage study
  1. Gillian Libby1,
  2. Karen N Barnett2,
  3. Callum G Fraser3,
  4. Robert J C Steele3
  1. 1Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds Faculty of Medicine and Health, Leeds, West Yorkshire, UK
  2. 2Division of Public Health and Genomics, University of Dundee School of Medicine, Dundee, Scotland, UK
  3. 3Centre for Research into Cancer Prevention & Screening, University of Dundee School of Medicine, Dundee, Scotland, UK
  1. Correspondence to Professor Callum G Fraser, Centre for Research into Cancer Prevention & Screening, University of Dundee School of Medicine, Dundee, Scotland, UK; c.g.fraser{at}


Aims The presence of detectable faecal haemoglobin (f-Hb) has been shown to be associated with all-cause mortality and with death from a number of chronic diseases not known to cause gastrointestinal blood loss. This effect is independent of taking medicines that increase the risk of bleeding. To further investigate the association of f-Hb with chronic disease, the relationship between f-Hb and prescription of medicines for a variety of conditions was studied.

Methods All subjects (134 192) who participated in guaiac faecal occult blood test (gFOBT) screening in Tayside, Scotland, between March 2000 and March 2016, were studied in a cross-sectional manner by linking their gFOBT result (abnormal or normal) with prescribing data at the time of the test.

Results The screening participants with an abnormal gFOBT result were more likely to have been being prescribed medicines for heart disease, hypertension, diabetes and depression than those with a normal test result. This association persisted after adjustment for sex, age and deprivation (OR 1.35 (95%CI 1.23 to 1.48), 1.39 (1.27 to 1.52), 1.35 (1.15 to 1.58), 1.36 (1.16 to 1.59), all p<0.0001, for the four medicine categories, respectively).

Conclusions The results of this study confer further substantial weight to the concept that detectable f-Hb is associated with a range of common chronic conditions that have a systemic inflammatory component; we speculate that f-Hb might have potential in identifying individuals who are high risk of developing chronic conditions or are at an early stage of disease.

  • colorectal neoplasms
  • inflammation
  • colon

Statistics from


  • Handling editor Tahir S Pillay.

  • Contributors GL performed the statistical analyses and contributed to the writing of the manuscript. KNB contributed to the data analysis and the writing of the manuscript. CGF directed the gFOBT analyses from 2000 until 2010, participated in the analysis of results and contributed significantly to the writing of the manuscript. RJCS conceived the study, prepared the first and final drafts of the manuscript and is the guarantor for the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CGF undertook consultancy with Immunostics Inc., Ocean, New Jersey, USA, the manufacturer of the gFOBT kits used in the Pilot and Programme.

  • Patient consent for publication Not required.

  • Ethics approval Formal ethical approval for the study was not required because individual participants were not approached and only routinely collected population-based data were used.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request to Professor Robert JC Steele.

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