An observational study of replicate faecal immunochemical tests in the urgently referred symptomatic cohort.

Autor:	Farkas NG; Minimal Access Therapy and Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK., O'Brien J; Minimal Access Therapy and Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK., Whyte M; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK., Jourdan I; Minimal Access Therapy and Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK., Rockall T; Minimal Access Therapy and Training Unit (MATTU), Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK., Benton SC; Department of Clinical Biochemistry, Royal Surrey County Hospital, Berkshire and Surrey Pathology Services, Guildford, Surrey, UK.
Jazyk:	angličtina
Zdroj:	Annals of clinical biochemistry [Ann Clin Biochem] 2023 Sep; Vol. 60 (5), pp. 313-319. Date of Electronic Publication: 2023 Mar 14.
DOI:	10.1177/00045632231163425
Abstrakt:	Introduction: Triage of patients with suspected colorectal cancer (CRC) utilises a single faecal immunochemical test (FIT) at a defined threshold. Limited evidence exists regarding whether replicate FIT improves the positive and negative predictive value in symptomatic patients. This study examines urgently referred symptomatic patients undergoing replicate FIT. Primary aim is to assess two FITs and CRC/serious bowel disease. Secondary aims are to determine correlation and utility of replicate FIT. Methodology: Patients carried out one additional FIT during COVID-19 pandemic. FIT 1 and FIT 2 (the replicate sample) were analysed in relation to symptoms, diagnoses, investigations, future colonoscopy and missed CRC. Study period was 01/03/2020-31/07/2020. Three subgroups were compared; double positive (≥10 μg Hb/g faeces), double negative, and discordant FIT (one positive). Results: 111 patients had replicate FIT (50 male, 61 female). 43 (38.7%) patients had double negative, 32 (28.8%) double positive and 36 (32.4%) had discordant FITs. Median time between FITs was 14 days (IQR = 11-19). 83% of double positive patients underwent colonoscopy/virtual colonoscopy (61% in double negative patients). Six CRC and one high-risk polyp were in double positive patients (none in other groups). One discordant patient was not investigated and a CRC missed. Conclusions: Replicate FIT as a triage strategy appears most effective where both FITs are negative. CRC risk is low when FIT results are discordant. Double negative FITs are reassuring given benign associated diagnoses, or for patients where endoscopic investigation is high-risk. Larger studies are required to evaluate discordant FITs, enabling refinement of urgent investigation pathways. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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