Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK.
Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, South Yorkshire, UK.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241228161. doi: 10.1177/21501319241228161.
INTRODUCTION/OBJECTIVES: The fecal immunochemical test (FIT) helps triage primary care patients at risk of colorectal cancer (CRC). Improving FIT returns has received recent attention, however uncertainty exists regarding the accurate completion of samples provided for laboratory analysis. This study aims to identify the rejection rate of returned FIT samples and determine rejection causes.
FIT samples from symptomatic patients within South Yorkshire, Bassetlaw, and North Derbyshire are processed at a central laboratory. Tests requests are made from 225 GP practices, which serve an estimated 2 million population. This study describes a retrospective review of FIT samples received in the central laboratory between 01/09/19 and 31/12/22. Locally held data was interrogated in March 2023 to determine the number of FIT samples received and rejected during the study period. Documented reasons for rejection were explored to identify common themes.
Total FIT specimens received during the study period was 126 422. Of these, 5190 (4.1%) were rejected. Monthly rejection rates fell from 17.4% in September 2019 to 1.3% in December 2022 ( < .001). Sampling errors were the most frequent cause for FIT rejection (2151/5190), with other causes including: expired specimen; no sample collection date/ time, no request form, incomplete patient information and illegible handwriting.
This is the first study exploring FIT rejection rates in symptomatic primary care patients, which shows improvements in rejection rates over time. Targeted interventions could improve rejection rates further, thereby reducing NHS resource use and costs and diagnostic delays.
简介/目的：粪便免疫化学测试（FIT）有助于对有结直肠癌（CRC）风险的初级保健患者进行分诊。最近，人们关注提高 FIT 回报，然而，对于提供给实验室分析的样本的准确完成情况仍存在不确定性。本研究旨在确定返回的 FIT 样本的拒收率，并确定拒收原因。
在南约克郡、巴塞特劳和北德比郡的中心实验室对有症状的患者的 FIT 样本进行处理。测试请求来自 225 个全科医生诊所，为估计 200 万人口提供服务。本研究描述了对 2019 年 9 月 1 日至 2022 年 12 月 31 日期间在中心实验室收到的 FIT 样本的回顾性审查。2023 年 3 月对本地持有的数据进行了查询，以确定研究期间收到和拒收的 FIT 样本数量。探索记录的拒收原因，以确定常见主题。
在研究期间共收到 126422 份 FIT 标本。其中，5190 份（4.1%）被拒收。拒收率从 2019 年 9 月的 17.4%逐月下降到 2022 年 12 月的 1.3%（ < .001）。采样错误是 FIT 拒收的最常见原因（2151/5190），其他原因包括：标本过期；无样本采集日期/时间、无请求表、患者信息不完整和字迹难以辨认。
这是第一项探索初级保健症状患者 FIT 拒收率的研究，表明随着时间的推移，拒收率有所提高。有针对性的干预措施可以进一步提高拒收率，从而减少国民保健服务的资源使用和成本以及诊断延迟。
