Replicate and repeat faecal immunochemical tests in symptomatic patients: A systematic review.

Area of Science:

• Gastroenterology
• Oncology
• Diagnostic Medicine

Background:

• Faecal Immunochemical Tests (FIT) are commonly used for symptomatic patients, typically with a single sample.
• Limited evidence exists for replicate FIT (multiple tests before decision-making) or repeat FIT (additional tests after decision-making).
• Research predominantly focuses on FIT for colorectal cancer (CRC) detection.

Approach:

• A systematic literature review was conducted using EMBASE, Medline, and PubMed databases.
• Search terms included 'faecal immunochemical test' or 'FIT' combined with 'multiple' or 'repeat'.
• All English-language papers with no date restrictions up to November 2021 were included.

Key Points:

• Seven studies were included from 161 initial papers screened.
• Most studies assessed if replicate FIT increased CRC diagnostic yield, using colonoscopy as the gold standard.
• Findings on replicate FIT's impact on CRC detection were conflicting, with some suggesting improved diagnosis and others showing no significant increase.

Conclusions:

• Current evidence on replicate and repeat FIT in symptomatic patients is minimal and contradictory.
• While FIT is a valuable tool, its application requires further investigation.
• Additional research is necessary to establish consensus and guide the use of replicate and repeat FIT.