Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Jul;23(7):1622-1629.
doi: 10.1111/codi.15408. Epub 2020 Nov 7.

Adoption of faecal immunochemical testing for 2-week-wait colorectal patients during the COVID-19 pandemic: an observational cohort study reporting a new service at a regional centre

William Maclean  1 , Chris Limb  1 , Paul Mackenzie  1 , Martin B Whyte  2 , Sally C Benton  3 , Timothy Rockall  1 , Iain Jourdan  1
Affiliations
Observational Study

Adoption of faecal immunochemical testing for 2-week-wait colorectal patients during the COVID-19 pandemic: an observational cohort study reporting a new service at a regional centre

William Maclean et al. Colorectal Dis. 2021 Jul.

Abstract

Aim: The COVID-19 pandemic has resulted in the near-complete loss of routine endoscopy services. We describe a major reorganization of service at a regional referral centre (Royal Surrey NHS Foundation Trust) to manage the crisis. Faecal immunochemical testing (FIT) was implemented for triage to make optimum use of limited diagnostic resources. Consultations were switched from face-to-face to telephone. Our aim was to evaluate the impact FIT had on resource allocation and patient diagnoses in the first 3 months of use.

Method: All colorectal 2-week-wait patient referrals were posted a pack requesting FIT and notification of telephone consultation. A prepaid envelope was included for return of the samples. At consultation, FIT was incorporated with the presenting symptoms to guide the choice of investigation and triage urgency. FIT ≥10 μg/g was interpreted as positive. Outcome data were collected prospectively and compared with retrospective audit data from prepandemic levels across 3 months.

Results: From 26 March 2020 to 2 July 381 patients were referred who were invited to provide FIT samples and underwent telephone consultations. Three hundred and fifty eight FIT samples were returned (94%). Onward referral for colonoscopy reduced from 62% to 34% (P < 0.001). There were 14 colorectal cancers (CRC) (3.7%) diagnosed, which was not statistically different from the prepandemic level of 3.9% (P = 0.995). Twelve of the 14 patients with a CRC diagnosis had provided samples; all 12 had FIT ≥10 μg/g and were offered fast-track investigations.

Conclusions: The incorporation of FIT optimized the allocation of limited resources to triage those who required urgent colonic investigation for detecting CRC.

Keywords: COVID-19; endoscopy; faecal immunochemical testing; two-week-wait.

PubMed Disclaimer

References

REFERENCES

    1. O’Leary MP, Choong KC, Thornblade LW, Fakih MG, Fong Y, Kaiser AM. Management considerations for the surgical treatment of colorectal cancer during the global Covid-19 pandemic. Ann Surg. 2020;272:e98-105.
    1. Sciubba DM, Ehresman J, Pennington Z, Lubelski D, Feghali J, Bydon A, et al. Scoring system to triage patients for spine surgery in the setting of limited resources: application to the coronavirus disease 2019 (COVID-19) pandemic and beyond. World Neurosurg. 2020;2019:e373-80.
    1. Fader AN, Huh WK, Kesterson J, Pothuri B, Wethington S, Wright JD, et al. Society of gynecologic oncology surgery considerations during when to operate, hesitate and reintegrate the COVID-19 pandemic. Gynecol Oncol. 2020:158:236-43.
    1. Ceely G, Office for National Statistics. Analysis of death registrations not involving coronavirus (COVID-19), England and Wales - Office for National Statistics. 2020;1-30. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri.... Accessed 5 June 2020
    1. De Vincentiis L, Carr RA, Mariani MP, Ferrara G. Cancer diagnostic rates during the “lockdown”, due to COVID-19 pandemic, compared with the 2018-2019: an audit study from cellular pathology. J Clin Pathol. 2020;2020:1-3.

Publication types

LinkOut - more resources