ArticleAlimentary pharmacology & therapeutics2025
COLOFIT: Development and Internal-External Validation of Models Using Age, Sex, Faecal Immunochemical and Blood Tests to Optimise Diagnosis of Colorectal Cancer in Symptomatic Patients.
Article in Alimentary pharmacology & therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.BMC gastroenterology · 2026Pooled 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
- Baseline characteristics of participants recruited into the COLO-COHORT study: a UK-wide resource for colorectal cancer prevention.BMJ open gastroenterology · 2026Observational
- Blood test trend versus single threshold abnormality to discriminate cancer from non-cancer in patients with unexpected weight loss: A retrospective cohort study.PLoS medicine · 2026Article
- Faecal haemoglobin-based referral and investigation prioritisation is associated with colorectal cancer-specific survival in symptomatic patients: a retrospective observational study.British journal of cancer · 2026Observational
- Article
- Real-World Performance of FIT Triage for Symptomatic Colonoscopy: Analysis of the UK National Endoscopy Database (NED).Alimentary pharmacology & therapeutics · 2026Article
- Is now the time to rethink risk thresholds in cancer referral guidelines?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- 3D dynamic magnetic microfluidic chip for efficient plasma extracellular vesicle enrichment and machine learning-based multiparametric diagnosis of hepatocellular carcinoma.Journal of nanobiotechnology · 2025Article
- Article
- Machine learning-based prediction of clinical outcomes in cervical cancer using routine hematological indices: development and web implementation.Frontiers in oncology · 2025Article
- Cost-effectiveness of FIT and a FIT-based model to optimise symptomatic diagnosis of colorectal cancer: health economic modelling for the COLOFIT project.BMJ public health · 2025Article
- 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
- Stacked random forest model for colorectal cancer detection using complete blood counts.Digital healthArticle
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14 authors.
Funding
Abstract
backgroundColorectal cancer (CRC) is the third most common cancer in the United Kingdom and the second largest cause of cancer death.
aimTo develop and validate a model using available information at the time of faecal immunochemical testing (FIT) in primary care to improve selection of symptomatic patients for CRC investigations.
methodsWe included all adults (≥ 18 years) referred to Nottingham University Hospitals NHS Trust between 2018 and 2022 with symptoms of suspected CRC who had a FIT. Predicted 1-year CRC diagnosis were calculated, and externally validated, using Cox proportional hazards modelling with selected multiple fractional polynomial transformations for age, faecal haemoglobin concentration (f-Hb) value, mean corpuscular volume (MCV), platelet count and sex.
resultsAt a CRC risk threshold of 0.6% (equivalent to f-Hb = 10 μg Hb/g (μg/g)) overall performance of the validated model across age strata using Harrell's C index was ≥ 0.91% (overall C-statistic 93%, 95% CI 92%-95%) with acceptable calibration. Using this model yields similar numbers of detected and missed cancers, but requires ~20% fewer investigations than a f-Hb ≥ 10 μg/g strategy. For approximately 100,000 people per year with symptoms of suspected CRC, we predict it might save > 4500 colonoscopies with no evidence that more cancers would be missed if we used our model compared to using FIT f-Hb ≥ 10 μg/g.
conclusionsIncluding age, sex, MCV, platelets and f-Hb in a survival analysis model to predict the risk of CRC yields greater diagnostic utility than a simple binary cut off f-Hb ≥ 10 μg/g.
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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.