Observational studyGut2025
Combining faecal haemoglobin, iron deficiency anaemia status and age can improve colorectal cancer risk prediction in patients attending primary care with bowel symptoms: a retrospective observational study.
Observational study in Gut, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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.
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Who cites it
4 citing papers in PubMed.
- Risk Stratification to Optimize Colorectal Cancer Screening: Development and Validation of a Decision-Tree Model for Colonoscopy Prioritization.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 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
- Real-World Performance of FIT Triage for Symptomatic Colonoscopy: Analysis of the UK National Endoscopy Database (NED).Alimentary pharmacology & therapeutics · 2026Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn primary care, National Institute for Health and Care Excellence suspected cancer guidelines recommend measuring faecal haemoglobin (f-Hb) if colorectal cancer (CRC) is suspected, with a referral threshold of ≥10 µg Hb/g faeces defining a 3% risk, but most have a normal colonoscopy.
objectiveExamine whether combining f-Hb, patient age and iron-deficient anaemia (IDA) status improves risk prediction.
designRetrospective single-centre observational study of symptomatic patients who submitted contemporaneous f-Hb and full blood count (FBC) samples between December 2015 and December 2019. f-Hb was estimated using HM-JACKarc (Hitachi Chemical Diagnostics Systems). Patients were categorised by presence/absence of IDA. Incident CRC was identified via record linkage to the Scottish Cancer Registry. Kaplan-Meier estimates determined cumulative 1-year CRC risk by patient age, f-Hb result and presence of IDA.
resultsOf 34 647 valid f-Hb results retrieved; 7889 (22.8%) had f-Hb≥10 µg Hb/g. Of these, 33 285 samples (96.1%) had associated FBC results of which 3000 (9.0%) had IDA. Overall, 571 incident CRC were recorded. The risk of CRC breached 3% in patients with f-Hb>99 µg Hb/g aged >40 years and reached 30% (19.4-41.0) with f-Hb>99 µg Hb/g in age >55 years plus IDA. 2029 f-Hb results (25.7%) were in the 10-19 µg Hb/g range of which 27 (1.3%) had CRC. In this subgroup, CRC risk did not exceed 3% in patients <85 years and no IDA.
conclusionCombining f-Hb, patient age and IDA status improves CRC risk prediction, identifies a low-risk group with f-Hb<20 µg Hb/g and no IDA and could inform revised referral guidance.
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