Evidence map›Paper›PMID 39690130›Full record

ReviewColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2024

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.

Sue Harnan, Jean Hamilton, Emma Simpson, Mark Clowes, Aline Navega Biz, Sophie Whyte, Shijie Ren, Katy Cooper, Muti Abulafi, Alex Ball and 11 more

Abstract readReview
In one paragraph

Review in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Positive Predictive Value of Symptoms for Early-Onset Colorectal Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
    Article
  2. Review
  3. Article
  4. Review
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

21 authors.

Sue HarnanSCHARR, University of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0002-9318-9206
Jean HamiltonSCHARR, University of Sheffield, Sheffield, UK.
Emma SimpsonSCHARR, University of Sheffield, Sheffield, UK.
Mark ClowesSCHARR, University of Sheffield, Sheffield, UK.
Aline Navega BizSCHARR, University of Sheffield, Sheffield, UK.
Sophie WhyteSCHARR, University of Sheffield, Sheffield, UK.
Shijie RenSCHARR, University of Sheffield, Sheffield, UK.
Katy CooperSCHARR, University of Sheffield, Sheffield, UK.
Muti AbulafiCroydon Health Services NHS Trust, London, UK.
Alex BallSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Sally BentonBerkshire and Surrey Pathology Services, Royal Surrey NHS Foundation Trust, Guildford, UK.
Richard BoothCroydon Health Services NHS Trust, London, UK.
Rachel CartenBuckinghamshire Healthcare NHS Trust, Buckinghamshire, UK.
Stephanie EdgarGP Lead for FIT, South Yorkshire CCG, Yorkshire, UK.
Willie HamiltonUniversity of Exeter Medical School, Exeter, UK.
Matthew KurienSt Mark's: National Bowel Hospital and Imperial College, London, UK.ORCID https://orcid.org/0000-0002-4227-9500
Louise MerrimanGP Lead for FIT, South Yorkshire CCG, Yorkshire, UK.
Kevin MonahanPopulation Health Sciences, University of Bristol, Bristol, UK.
Laura HeathcoteSt Mark's: National Bowel Hospital and Imperial College, London, UK.
Hayley E JonesPopulation Health Sciences, University of Bristol, Bristol, UK.
Matt StevensonSCHARR, University of Sheffield, Sheffield, UK.

Funding

National Institute for Health and Care Research
6 · The paper itself

Abstract

aimExtending faecal immunochemical tests for haemoglobin (FIT) to all primary care patients with symptoms suggestive of colorectal cancer (CRC) could identify people who are likely to benefit from colonoscopy and facilitate earlier treatment. The aim of this work was to investigate the diagnostic accuracy of FIT across different analysers at different thresholds, as a single test or in duplicate (dual FIT).

methodThis systematic review and meta-analysis searched 10 sources (December 2022). Diagnostic accuracy studies of HM-JACKarc, OC-Sensor, FOB Gold, QuikRead go, NS-Prime and four Immunodiagnostik (IDK) tests in primary care patients were included. Risk of bias was assessed (QUADAS-2). Statistical syntheses produced summary estimates of sensitivity and specificity at any chosen threshold for CRC, inflammatory bowel disease and advanced adenomas separately. Sensitivity analyses investigated reference standard and population type (high, low or all-risk). Subgroup analyses investigated patient characteristics (e.g. anaemia, age, sex, ethnicity).

resultsThirty-seven studies were included. At a threshold of 10 μg/g, pooled results for sensitivity and specificity (95% credible intervals) for CRC, respectively, were: HM-JACKarc (n = 16 studies) 89.5% (84.6%-93.4%) and 82.8% (75.2%-89.6%); OC-Sensor (n = 11 studies) 89.8% (85.9%-93.3%) and 77.6% (64.3%-88.6%); FOB Gold (n = 3 studies), 87.0% (67.3%-98.3%) and 88.4% (81.7%-94.2%). There were limited or no data on the other tests, dual FIT and relating to patient characteristics.

conclusionTest sensitivity at a threshold of 10 μg/g highlights a requirement for adequate safeguards in test-negative patients with ongoing symptoms. Further research is needed into the impact of patient characteristics and dual FIT.

Indexed as

adenomascolorectal cancerdiagnostic test accuracyfaecal immunochemical testinflammatory bowel diseaseprimary caresystematic review

Identifiers

PMID39690130
PMCPMC11683176

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Registered trials

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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.