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. 2013 Jun;1(3):198-205.
doi: 10.1177/2050640613489281.

Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

Robert Jc Steele  1 , Paula J McDonald  2 , Jayne Digby  2 , Linda Brownlee  2 , Judith A Strachan  2 , Gillian Libby  2 , Paula L McClements  3 , Janice Birrell  4 , Francis A Carey  5 , Robert H Diament  6 , Margaret Balsitis  7 , Callum G Fraser  8
Affiliations

Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

Robert Jc Steele et al. United European Gastroenterol J. 2013 Jun.

Abstract

Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.

Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.

Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.

Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.

Keywords: Colorectal cancer; faecal immunochemical test; faecal occult blood test; positive predictive value; screening.

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References

    1. Segnan N, Patnick J, von Karsa L. European guidelines for quality assurance in colorectal screening and diagnosis, 1st ed Luxembourg: Publication Offices of the European Union, 2010
    1. Hewitson P, Glasziou P, Watson E, et al. Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (Hemoccult): An update. Am J Gastroenterol 2008; 103: 1541–1549 - PubMed
    1. Steele RJC, McClements P, Libby G, et al. Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer. Gut 2009; 58: 530–535 - PubMed
    1. Moss SM, Campbell C, Melia J, et al. Performance measures in three rounds of the English bowel cancer screening pilot. Gut 2012; 61: 101–107 - PMC - PubMed
    1. Fraser CG. Fecal occult blood tests.. Life savers or outdated colorectal screening tools? Clin Lab News 2011; 37: 8–10