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Implementation of immunochemical faecal occult blood test in general practice: a study protocol using a
Jakob Søgaard Juul1,2, Flemming Bro3, Nete Hornung4
1Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. j.juul@ph.au.dk.
BMC Cancer
|July 13, 2016
Summary
This study assesses the implementation of the immunochemical faecal occult blood test (iFOBT) in Danish general practice for diagnosing colorectal cancer. Findings will inform future colorectal cancer screening strategies for low-risk patients.
Area of Science:
- Oncology
- Primary Care Medicine
- Diagnostic Testing
Background:
- Colorectal cancer is a leading cause of cancer death, often presenting with vague symptoms.
- Early detection is crucial, and the immunochemical faecal occult blood test (iFOBT) offers a safe, low-cost diagnostic option.
- Danish general practitioners currently have limited access to iFOBT, necessitating an evaluation of its implementation.
Purpose of the Study:
- To assess the uptake and clinical utility of iFOBT in general practice for patients with non-alarm symptoms.
- To investigate the diagnostic accuracy and clinical implications of using iFOBT in primary care settings.
- To provide evidence for the effective integration of iFOBT into colorectal cancer diagnostic pathways.
Main Methods:
- A cluster-randomised stepped-wedge design involving 836 general practitioners across 381 practices in the Central Denmark Region.
- Sequential inclusion of municipalities and general practitioners over a 7-month period within a 1-year study.
- A mandatory intervention including iFOBT kits, clinical instructions, and online materials, complemented by optional continuous medical education.
Main Results:
- The study is designed to evaluate the impact of iFOBT implementation on diagnostic practices.
- It aims to quantify the diagnostic value and clinical implications of iFOBT in primary care for colorectal cancer detection.
- Results will provide insights into the feasibility and effectiveness of iFOBT in a real-world general practice setting.
Conclusions:
- This trial is one of the largest investigating iFOBT's diagnostic use in patients with non-alarm colorectal cancer symptoms.
- Findings are expected to have significant national and international implications for colorectal cancer diagnostics planning.
- The study will guide the integration of iFOBT for 'low-risk-but-not-no-risk' individuals in primary care.
