Observational studyBritish journal of cancer2022
Faecal immunochemical test for patients with 'high-risk' bowel symptoms: a large prospective cohort study and updated literature review.
Observational study in British journal of cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Quantitative faecal immunochemical tests to guide colorectal cancer pathway referral in primary care. A systematic review, meta-analysis and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2025Pooled it
- Guideline
- Microbiomics: Novel Biomarkers of Colorectal Cancer Diagnosis and Prognosis.Diagnostics (Basel, Switzerland) · 2026Review
- Triaging colorectal urgent referrals in the COVID-19 era using faecal immunochemical testing: a prospective UK real-world multicentre cohort study.BMJ open gastroenterology · 2025Observational
- Faecal immunochemical tests for patients with symptoms suggestive of colorectal cancer: An updated systematic review and multiple-threshold meta-analysis of diagnostic test accuracy studies.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Review
- Faecal haemoglobin concentration and colorectal cancer site, stage and grade in a symptomatic cohort.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- Diagnostic application of the ColonFlag AI tool in combination with faecal immunochemical test in patients on an urgent lower gastrointestinal cancer pathway.BMJ open gastroenterology · 2024Article
- 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 · 2023Article
- Double faecal immunochemical testing in patients with symptoms suspicious of colorectal cancer.The British journal of surgery · 2023Article
- Faecal immunochemical testing for haemoglobin in detecting bowel polyps in symptomatic patients: multicentre prospective cohort study.BJS open · 2023Observational
- Role of the faecal immunochemical test in patients with risk-stratified suspected colorectal cancer symptoms: A systematic review and meta-analysis to inform the ACPGBI/BSG guidelines.The Lancet regional health. Europe · 2022Article
- Article
- Article
- A cohort study of duplicate faecal immunochemical testing in patients at risk of colorectal cancer from North-West England.BMJ open · 2022Article
- The state of the faecal immunochemical test in symptomatic patients in the UK.Annals of the Royal College of Surgeons of England · 2022Article
- The Fast Track FIT study: diagnostic accuracy of faecal immunochemical test for haemoglobin in patients with suspected colorectal cancer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Short-term outcomes of a COVID-adapted triage pathway for colorectal cancer detection.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Use of ColonFlag score for prioritisation of endoscopy in colorectal cancer.BMJ open gastroenterology · 2021Article
- COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist.Digestive diseases (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe evaluated whether faecal immunochemical testing (FIT) can rule out colorectal cancer (CRC) among patients presenting with 'high-risk' symptoms requiring definitive investigation.
methodsThree thousand five hundred and ninety-six symptomatic patients referred to the standard urgent CRC pathway were recruited in a multi-centre observational study. They completed FIT in addition to standard investigations. CRC miss rate (percentage of CRC cases with low quantitative faecal haemoglobin [f-Hb] measurement) and specificity (percentage of patients without cancer with low f-Hb) were calculated. We also provided an updated literature review.
resultsNinety patients had CRC. At f-Hb < 10 µg/g, the miss rate was 16.7% (specificity 80.1%). At f-Hb < 4 µg/g, the miss rate was 12.2% (specificity 73%), which became 3.3% if low FIT plus the absence of anaemia and abdominal pain were considered (specificity 51%). Within meta-analyses of 9 UK studies, the pooled miss rate was 7.2% (specificity 74%) for f-Hb < 4 µg/g. DISCUSSION: FIT alone as a triage tool would miss an estimated 1 in 8 cases in our study (1 in 14 from meta-analysis), while many people without CRC could avoid investigations. FIT can focus secondary care diagnostic capacity on patients most at risk of CRC, but more work on safety netting is required before incorporating FIT triage into the urgent diagnostic pathway.
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