Evidence map›Paper›PMID 33798091›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2021

The Fast Track FIT study: diagnostic accuracy of faecal immunochemical test for haemoglobin in patients with suspected colorectal cancer.

James L Turvill, Daniel Turnock, Dan Cottingham, Monica Haritakis, Laura Jeffery, Annabelle Girdwood, Tom Hearfield, Alex Mitchell, Ada Keding

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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

25 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  13. Sociodemographic variations in the uptake of faecal immunochemical tests in primary care: a retrospective study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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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

9 authors.

James L TurvillDepartment of Gastroenterology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Daniel TurnockDepartment of Gastroenterology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Dan CottinghamMacmillan GP Cancer and End of Life lead, Vale of York Clinical Commissioning Group, West Offices Station Rise, York.
Monica HaritakisDepartment of Research and Development, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Laura JefferyDepartment of Research and Development, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Annabelle GirdwoodDepartment of Research and Development, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Tom HearfieldDepartment of Research and Development, York and Scarborough Teaching Hospitals NHS Foundation Trust, York.
Alex MitchellDepartment of Health Sciences, Faculty of Sciences, University of York, York.
Ada KedingDepartment of Health Sciences, Faculty of Sciences, University of York, York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe faecal immunochemical test (FIT) is now available to support clinicians in the assessment of patients at low risk of colorectal cancer (CRC) and within the bowel cancer screening programme.

aimTo determine the diagnostic accuracy of FIT for CRC and clinically significant disease in patients referred as they were judged by their GP to fulfil National Institute for Health and Care Excellence guideline 12 (NG12) criteria for suspected CRC. DESIGN AND

settingPatients referred from primary care with suspected CRC, meeting NG12 criteria, to 12 secondary care providers in Yorkshire and Humber were asked to complete a FIT before investigation.

methodThe diagnostic accuracy of FIT based on final diagnosis was evaluated using receiver operating characteristics analysis. This permitted a statistically optimal cut-off value for FIT to be determined based on the maximisation of sensitivity and specificity. Clinicians and patients were blinded to the FIT results.

resultsIn total, 5040 patients were fully evaluated and CRC was detected in 151 (3.0%). An optimal cut-off value of 19 µg Hb/g faeces for CRC was determined, giving a sensitivity of 85.4% (95% confidence interval [CI] = 78.8% to 90.6%) and specificity of 85.2% (95% CI = 84.1% to 86.2%). The negative predictive value at this cut-off value was 99.5% (95% CI = 99.2% to 99.7%) and the positive predictive value 15.1% (95% CI = 12.8% to 17.7%). Sensitivity and specificity of FIT for CRC and significant premalignant polyps at this cut-off value were 62.9% (95% CI = 57.5% to 68.0%) and 86.4% (95% CI = 85.4% to 87.4%), respectively; and when including all organic enteric disease were 35.7% (95% CI = 32.9% to 38.5%) and 88.6% (95% CI = 87.5% to 89.6%), respectively.

conclusionFIT used in patients fulfilling NG12 criteria should allow for a more personalised CRC risk assessment. FIT should permit effective, patient-centred decision-making to inform the need for, type, and timing of further investigation.

Indexed as

Colorectal NeoplasmsColonoscopyEarly Detection of CancerFecesHemoglobinsHumansOccult BloodSensitivity and SpecificityHemoglobinscolorectal neoplasmsearly detection of cancerfecespredictive value of tests

Identifiers

PMID33798091
PMCPMC8279659

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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.