Farkas Nicholas G, Fraser Callum G, Maclean William, Jourdan Iain, Rockall Tim, Benton Sally C
Minimal Access Therapy and Training Unit (MATTU), 3661Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
Centre for Research Into Cancer Prevention and Screening, Population Health and Genomics, School of Medicine, 85326University of Dundee, Scotland, UK.
Ann Clin Biochem. 2023 Jan;60(1):27-36. doi: 10.1177/00045632221096036. Epub 2022 May 5.
Faecal Immunochemical tests (FITs) in the assessment of patients presenting with symptoms have generally used a single sample. Little evidence pertains to the use of replicate, where a number of tests are done prior to decision-making or repeat FIT, where additional FIT are performed following clinical decision-making. Overwhelmingly, research has focussed on FIT to help identify colorectal cancer (CRC). The aim of this review is to assess the available literature concerning replicate and repeat FIT in symptomatic patients to help generate consensus and guide future research.
The terms 'faecal immunochemical test' or 'FIT' were combined with 'multiple' or 'repeat'. EMBASE, Medline and PubMed database and other searches were conducted. All papers published in English were included with no exclusion date limits until November 2021.
Of the 161 initial papers screened, seven were included for review. Qualitative and quantitative FIT outcomes were assessed in the studies. The primary aims of most related to whether replicate FIT increased diagnostic yield of CRC, with colonoscopy used as the reference standard. One publication assessed the impact of a new COVID-adapted pathway on CRC detection. No consensus on replicate FIT was apparent. Some concluded that FITs may help minimise missed CRC diagnoses: others showed no increase in diagnostic yield of CRC.
Current evidence on replicate and repeat FIT is both minimal and conflicting. FIT is a superb clinical tool, but significant gaps surrounding application remain. Further studies relating to replicate and repeat FIT are required.
粪便免疫化学检测（FIT）在对有症状患者的评估中通常采用单个样本。关于重复检测（即在决策前进行多次检测）或重复FIT（即在临床决策后进行额外的FIT检测）的使用证据很少。绝大多数研究都集中在FIT用于帮助识别结直肠癌（CRC）。本综述的目的是评估有关有症状患者重复和再次FIT的现有文献，以帮助达成共识并指导未来研究。
将术语“粪便免疫化学检测”或“FIT”与“多次”或“重复”相结合。对EMBASE、Medline和PubMed数据库以及其他来源进行了检索。纳入所有截至2021年11月发表的英文论文，无排除日期限制。
在最初筛选的161篇论文中，7篇被纳入综述。在研究中评估了定性和定量FIT结果。大多数研究的主要目的是重复FIT是否提高了CRC的诊断率，以结肠镜检查作为参考标准。一篇出版物评估了一种新的适应新冠疫情的检测途径对CRC检测的影响。关于重复FIT没有明显的共识。一些研究得出结论，FIT可能有助于尽量减少漏诊的CRC病例：另一些研究则表明CRC的诊断率没有提高。
目前关于重复和再次FIT的证据既少又相互矛盾。FIT是一种出色的临床工具，但在应用方面仍存在重大差距。需要进一步开展与重复和再次FIT相关的研究。
