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Faecal haemoglobin: Measurement, applications, and future potential.

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Faecal immunochemical tests (FIT) for hemoglobin (f-Hb) are valuable for colorectal cancer screening and symptom assessment. Factors like sex and age influence results, necessitating tailored thresholds for equitable screening and risk assessment.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Clinical Chemistry

Background:

  • Faecal hemoglobin (f-Hb) measured by faecal immunochemical tests (FIT) is crucial for colorectal cancer (CRC) screening and diagnostics.
  • FIT systems are widely used but influenced by factors like sex, age, and geographical region, impacting data transferability.
  • Women may be disadvantaged by uniform f-Hb thresholds, highlighting the need for risk scoring or sex-specific cutoffs.

Purpose of the Study:

  • To evaluate the utility of FIT in CRC screening and patient assessment.
  • To explore the impact of various factors on f-Hb measurements.
  • To discuss potential improvements and expanded applications of FIT technology.

Main Methods:

  • Quantification of faecal hemoglobin concentrations using FIT analytical systems.
  • Analysis of factors influencing f-Hb levels, including demographics and FIT system variations.
  • Review of current applications and potential future research directions for FIT.

Main Results:

  • FIT is valuable in CRC screening and assessing symptomatic patients, especially where colonoscopy resources are limited.
  • Elevated f-Hb can indicate CRC risk, even below the screening threshold, and is also observed in systemic inflammatory conditions.
  • FIT shows promise in post-polypectomy surveillance, potentially reducing healthcare costs.

Conclusions:

  • FIT is a mature tool for f-Hb estimation with established value in CRC screening and diagnostics.
  • Addressing variability through risk scoring or sex-stratified thresholds can improve equity.
  • Further research into lower detection limits and utilizing residual sample material could expand FIT applications.