Faecal Immunochemical Test (FIT) Value-Based Algorithm to Triage Symptomatic Colorectal Patients: A Retrospective...

Area of Science:

• Gastroenterology
• Oncology
• Diagnostic Medicine

Background:

• Colorectal cancer (CRC) diagnosis relies on timely investigation of symptomatic patients.
• Faecal immunochemical testing (FIT) is a non-invasive screening tool for lower gastrointestinal bleeding.
• Optimizing patient prioritization for urgent colorectal investigations is crucial for effective healthcare delivery.

Purpose of the Study:

• To evaluate the diagnostic accuracy of quantitative FIT in symptomatic patients with suspected colorectal cancer.
• To assess the utility of FIT in prioritizing patients for urgent colorectal investigations.
• To determine the effectiveness of FIT in managing healthcare resources for colorectal diagnostics.

Main Methods:

• Retrospective review of symptomatic, FIT-positive patients referred to a colorectal clinic (November 2021 - February 2022).
• Exclusion of patients under 18 years.
• Triage to test (TTT) or face-to-face (F2F) clinics based on a local algorithm.
• Statistical analysis of diagnostic accuracy, specificity, and positive predictive value (PPV) at various FIT cut-off values.

Main Results:

• Out of 915 FIT-positive patients, 9.8% were diagnosed with CRC.
• Higher FIT cut-off values (>100 and >200 μg Hb/g) showed increased specificity for CRC (88.10% and 92.27%, respectively).
• The number needed to scope decreased with higher FIT cut-off values, indicating improved prioritization efficiency.

Conclusions:

• Quantitative FIT is a valuable tool for diagnosing colorectal cancer in symptomatic individuals.
• FIT effectively aids in prioritizing patients for urgent colorectal investigations, optimizing resource allocation.
• Implementing quantitative FIT can enhance the efficiency of outpatient and endoscopy services for colorectal cancer diagnosis.