Boulbadaoui Amal, Bibi Ayesha, Mohamed Guleed, Gaunt Anne, Varghese Philip, Rashid Muhammad Umair
Colorectal Surgery, University Hospitals of North Midlands National Health Service Trust, Stoke-on-Trent, GBR.
General Surgery, University Hospitals Birmingham National Health Service Trust, Birmingham, GBR.
Cureus. 2024 Sep 21;16(9):e69889. doi: 10.7759/cureus.69889. eCollection 2024 Sep.
Background The aim was to evaluate the diagnostic accuracy of quantitative faecal immunochemical testing (FIT) in diagnosing colorectal cancer in symptomatic patients and using it to prioritize patients for urgent colorectal investigations. Methods A retrospective review was done of all symptomatic, FIT-positive patients referred from primary care to the colorectal clinic as per the National Institute for Health and Care Excellence (NICE) DG30 pathway from November 1, 2021, to February 11, 2022. Patients under 18 years of age were excluded. All patients were triaged to test (TTT) or booked in face-to-face (F2F) clinics according to a local algorithm. The data was collected in Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States), and statistical analysis was performed using IBM SPSS Statistics for Windows (IBM Corp., Armonk, New York, United States). Results Out of 915 FIT-positive patients, 774 (84.5%) patients were TTT and 70 (7.65%) were booked in F2F clinics. The mean age was 71 years, and the majority were females (n=488 (F:M = 53:47)). However, a higher prevalence of positive FIT test was observed in men than in women at higher cut-off values of >100 and >200 μg Hb/g faeces (18.79 % vs 17.48% and 12.78% vs 11.69%, respectively). The number needed to scope was 10.8, 6.03, and 5.20 at cut-off values of ≥10, >100, and >200 μg Hb/g, respectively. At cut-off values of ≥10, >100, and >200 μg Hb/g, the specificity for colorectal cancer (CRC) with a 95% confidence interval (95% CI) was 63.75 %, 88.10%, and 92.27 %, respectively, and the positive predictive value (PPV) was 9.63, 18.20, and 21.24, respectively. The majority of the patients (30.9%) had no pathology on colonoscopy, whereas CRC was detected in 9.8%. Conclusion Quantitative FIT in symptomatic colorectal patients can be used to triage patients to investigations more appropriately, reducing the burden on outpatient and endoscopy units and improving the overall efficacy of health provision.
目的是评估定量粪便免疫化学检测（FIT）在有症状患者中诊断结直肠癌的诊断准确性，并利用其为急需进行结直肠检查的患者确定优先顺序。方法：对2021年11月1日至2022年2月11日期间按照英国国家卫生与临床优化研究所（NICE）DG30路径从初级保健机构转诊至结直肠诊所的所有有症状、FIT阳性患者进行回顾性研究。排除18岁以下患者。所有患者根据当地算法被分诊至检测（TTT）或预约面对面（F2F）门诊。数据收集于Microsoft Excel（美国华盛顿州雷德蒙德市微软公司），并使用IBM SPSS Statistics for Windows（美国纽约州阿蒙克市IBM公司）进行统计分析。结果：在915例FIT阳性患者中，774例（84.5%）患者接受了TTT，7例（7.65%）预约了F2F门诊。平均年龄为71岁，大多数为女性（n = 488例（女性：男性 = 53:47））。然而，在粪便血红蛋白（Hb）>100 μg/g和>200 μg/g的较高临界值时，男性FIT检测阳性率高于女性（分别为18.79%对17.48%和12.78%对11.69%）。在临界值≥10 μg/g、>100 μg/g和>200 μg/g时，所需检查人数分别为10.8、6.03和5.20。在临界值≥10 μg/g、>100 μg/g和>200 μg/g时，结直肠癌（CRC）的特异性及95%置信区间（9
