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. 2023 Jun 23:128.
doi: 10.48101/ujms.v128.8869. eCollection 2023.

Accuracy of a faecal immunochemical test in patients under colonoscopy surveillance of colorectal adenoma and cancer

Louise Olsson  1   2 , Daniel Sjöberg  3
Affiliations

Accuracy of a faecal immunochemical test in patients under colonoscopy surveillance of colorectal adenoma and cancer

Louise Olsson et al. Ups J Med Sci. .

Abstract

Background: Surveillance of colorectal neoplasia place great strain on colonoscopy resources, and faecal immunochemical tests (FIT) are under-investigated for this purpose. The aim of this study was to report the outcome of FIT among patients scheduled for post-polypectomy and post-resection colorectal cancer (CRC) surveillance.

Methods: Patients scheduled for colonoscopy surveillance at five endoscopy units in mid-Sweden in 2016-2020 were eligible. They provided a faecal sample from 2 separate days, which were analysed by iFOBT QuikRead go® (Aidian Oy). Both the colonoscopies, and the FIT analyses were conducted by staff blinded to the other.

Results: Out of 216 included patients, 157 (73%) underwent both a complete colonoscopy and had at least one FIT analysed prior to the examination. The indication for surveillance was previous adenoma in 69 (44%) and post-resection CRC in 88 (56%) patients. Two (1%) in the CRC surveillance group were diagnosed with a metachronous CRC, whereas 49 (56%) patients in the CRC surveillance, and 17 (25%) in the adenoma group had no pathology identified at colonscopy (P < 0.001). The proportion of patients diagnosed with adenomas requiring surveillance according to European Society of Gastrointestinal Society (ESGE) guidelines 2020 was 6 (7%) in the post-CRC resection versus 7 (10%) in the adenoma surveillance group (P = 0.4). Based on one FIT and at cut-off 10 µg Hb/g, sensitivity for CRC was 100%, specificity 83% (95% confidence interval [CI]: 77-89), Positive Predictive Value (PPV) 7% (-2 to 16) and Negative Predictive Value (NPV) 100%. All patients with an adenoma requiring surveillance had a FIT below this cut-off. Adding a second FIT decreased the specificity.

Conclusion: Larger studies to evaluate the accuracy and consequences of using FIT for surveillance of colorectal neoplasia are needed. FIT may be more interesting for post-resection CRC surveillance than follow-up of adenoma.

Keywords: Colorectal cancer; adenoma; colonoscopy; faecal immunochemical test; surveillance.

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Conflict of interest statement

Aidian Oy provided a QuikRead go® instrument for analysis. The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
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References

    1. Gavin DR, Valori RM, Anderson JT, Donnelly MT, Williams JG, Swarbrick ET. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut. 2013;62:242–9. doi: 10.1136/gutjnl-2011-301848 - DOI - PubMed
    1. Hassan C, Antonelli G, Dumonceau JM, Regula J, Bretthauer M, Chaussade S, et al. . Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – update 2020. Endoscopy. 2020;52:687–700. doi: 10.1055/a-1185-3109 - DOI - PubMed
    1. Waldmann E, Kammerlander A, Gessl I, Penz D, Majcher B, Hinterberger A, et al. . New risk stratification after colorectal polypectomy reduces burden of surveillance without increasing mortality. United European Gastroenterol J. 2021;9:947–54. doi: 10.1002/ueg2.12119 - DOI - PMC - PubMed
    1. Atkin W, Cross AJ, Kralj-Hans I, MacRae E, Piggott C, Pearson S, et al. . Faecal immunochemical tests versus colonoscopy for post-polypectomy surveillance: an accuracy, acceptability and economic study. Health Technol Assess. 2019;23:1–84. doi: 10.3310/hta23010 - DOI - PMC - PubMed
    1. Maclean W, Zahoor Z, O’Driscoll S, Piggott C, Whyte MB, Rockall T, et al. . Comparison of the QuikRead go((R)) point-of-care faecal immunochemical test for haemoglobin with the FOB Gold Wide((R)) laboratory analyser to diagnose colorectal cancer in symptomatic patients. Clin Chem Lab Med. 2022;60:101–8. doi: 10.1515/cclm-2021-0655 - DOI - PubMed

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