Evidence map›Paper›PMID 33342370›Full record

ArticleJournal of medical screening2021

Faecal immunochemical testing in bowel cancer screening: Estimating outcomes for different diagnostic policies.

Shuping J Li, Linda D Sharples, Sally C Benton, Oleg Blyuss, Christopher Mathews, Peter Sasieni, Stephen W Duffy

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of medical screening, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. A guide to cancer screening.Nature reviews. Clinical oncology · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Shuping J LiWolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
Linda D SharplesDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Sally C BentonNHS Bowel Cancer Screening Programme, Royal County Hospital NHS Foundation Trust, Guildford, Surrey, UK.
Oleg BlyussSchool of Physics, Astronomy and Mathematics, University of Hertfordshire, Hertfordshire, UK.
Christopher MathewsSchool of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Peter SasieniSchool of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Stephen W DuffyWolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.ORCID 0000-0003-4901-7922
King's College London · GBQueen Mary University of London · GBCounty Hospital · GBLondon School of Hygiene & Tropical Medicine · GBUniversity of Hertfordshire · GB

Funding

Cancer Research UK 27047Department of Health RM-FI-2017–09-004
6 · The paper itself

Abstract

objectivesThe National Health Service Bowel Cancer Screening Programme (NHS BCSP) in England has replaced guaiac faecal occult blood testing by faecal immunochemical testing (FIT). There is interest in fully exploiting FIT measures to improve bowel cancer (CRC) screening strategies. In this paper, we estimate the relationship of the quantitative haemoglobin concentration provided by FIT in faecal samples with underlying pathology. From this we estimate thresholds required for given levels of sensitivity to CRC and high-risk adenomas (HRA).

methodsData were collected from a pilot study of FIT in England in 2014, in which 27,238 participants completed a FIT. Those with a faecal haemoglobin concentration (f-Hb) of at least 20 µg/g were referred for further investigation, usually colonoscopy. Truncated regression models were used to explore the relationship between bowel pathology and FIT results. Regression results were applied to estimate sensitivity to different abnormalities for a number of thresholds.

resultsParticipants with CRC and HRA had significantly higher f-Hb, and this remained unchanged after adjusting for age and sex. While a threshold of 20 μg/g was estimated to capture 82.2% of CRC and 64.0% of HRA, this would refer 7.8% of participants for colonoscopy. The current programme threshold used in England of 120 μg/g was estimated to identify 47.8% of CRC and 25.0% of HRA.

conclusionsUnder the current diagnostic policy of dichotomising FIT results, a very low threshold would be required to achieve high sensitivity to CRC and HRA, which would place further strain on colonoscopy resources. The NHS BCSP in England might benefit from a diagnostic policy that makes greater use of the quantitative nature of FIT.

Indexed as

Colorectal NeoplasmsOccult BloodColonoscopyEarly Detection of CancerFecesHemoglobinsHumansMass ScreeningPilot ProjectsPolicySensitivity and SpecificityState MedicineHemoglobinsBowel cancercolorectal cancerfaecal immunochemical testFIT thresholdsiFOBTscreening policies

Identifiers

PMID33342370
PMCPMC8366184
OpenAlexW3117372872

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.