Department of Colorectal Surgery, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK.
J Clin Pathol. 2013 Apr;66(4):330-4. doi: 10.1136/jclinpath-2011-200406. Epub 2013 Jan 2.
Faecal occult blood test (FOBt) is commonly requested by clinicians in both primary and secondary care. The aim of this study was to examine the use and outcomes of clinician-requested FOB testing in a single Trust taking part in the National Bowel Cancer Screening Programme pilots.
Data from a single Trust was used. The Trust's pathology reporting system was searched retrospectively for all FOBt study requests in 1 year. In patients with a positive test, the Trust's clinical results reporting system was searched to determine the type and outcome of any investigations. Patients with positive tests were cross-matched with the Trust's colorectal cancer database to detect interval cancers.
1363 FOB tests were requested during the calendar year. 715 (52.5%) were completed. Mean age was 60.6 years, 30.7% of patients were in the screening age group. 60 (4.4%) patients were FOBt positive. Total colonic imaging was performed in only 22% of those who were FOBt positive. Significant pathology was detected in five patients (0.4%) including three colonic carcinomas. There were no interval cancers in the FOBt-positive group.
The number of FOBt requests has increased with the introduction of a colorectal cancer screening programme. The FOBt completion rate and colonic imaging rate in FOBt-positive patients outside the national screening programme was low. Guidelines for the use of FOBt outside of screening are needed.
粪便潜血试验(FOBt)在初级和二级保健中均由临床医生常规要求。本研究的目的是检查参与国家结直肠癌筛查计划试点的单一信托基金中临床医生要求的 FOB 检测的使用情况和结果。
使用单一信托基金的数据。从信托基金的病理报告系统中回顾性搜索了 1 年内所有 FOBt 研究请求。在测试阳性的患者中,搜索信托基金的临床结果报告系统以确定任何调查的类型和结果。对阳性测试患者与信托基金的结直肠癌数据库进行交叉匹配,以检测间隔期癌症。
在日历年中请求了 1363 次 FOB 测试。完成了 715 次(52.5%)。平均年龄为 60.6 岁,30.7%的患者处于筛查年龄组。60 名(4.4%)患者 FOBt 阳性。仅对 22%的 FOBt 阳性患者进行了全结肠成像。在 5 名患者(0.4%)中检测到显著的病理学,包括 3 例结肠癌。在 FOBt 阳性组中未发现间隔期癌症。
随着结直肠癌筛查计划的引入,FOBt 请求数量有所增加。在国家筛查计划之外,FOBt 阳性患者的 FOBt 完成率和结肠成像率较低。需要制定 FOBt 在筛查之外使用的指南。