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Br J Cancer. 2018 Aug;119(4):471-479. doi: 10.1038/s41416-018-0178-7. Epub 2018 Aug 1.

The value of using the faecal immunochemical test in general practice on patients presenting with non-alarm symptoms of colorectal cancer.

Author information

1
Department of Public Health, Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. jsjuul.feap@outlook.dk.
2
Department of Public Health, Research Centre for Cancer Diagnosis in Primary Care, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. jsjuul.feap@outlook.dk.
3
Department of Clinical Biochemistry, Randers Regional Hospital, Skovlyvej 1, 8930, Randers, NE, Denmark.
4
Department of Public Health Programmes, Randers Regional Hospital, Skovlyvej 1, 8930, Randers, NE, Denmark.
5
Department of Surgery, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus C, Denmark.
6
Department of Public Health, Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
7
Department of Public Health, Research Centre for Cancer Diagnosis in Primary Care, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
8
Department of Clinical Medicine, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Aarhus University, Aarhus C, Denmark.

Abstract

BACKGROUND:

Around 50% of individuals with colorectal cancer (CRC) initially present with non-alarm symptoms.

METHODS:

We investigated the value of using the faecal immunochemical test (FIT) in the diagnostic process of CRC and other serious bowel disease in individuals presenting with non-alarm symptoms in general practice. The study was conducted in the Central Denmark Region from 1 September 2015 to 30 August 2016. The FIT was used as a rule-in test on patients aged ≥30 years with non-alarm symptoms of CRC. The cut-off value was set to 10 µg Hb/g faeces.

RESULTS:

A total of 3462 valid FITs were performed. Of these, 540 (15.6%) were positive. Three months after FIT performance, 51 (PPV: 9.4% (95% CI: 7.0;11.9)) individuals with a positive FIT were diagnosed with CRC and 73 (PPV: 13.5% (95%CI: 10.6;16.4)) with other serious bowel disease. Of CRCs, 66.7% were diagnosed in UICC stage I & II and 19.6% in stage IV. The false negative rate for CRC was <0.1% for the initial 3 months after FIT performance.

CONCLUSION:

The FIT may be used as a supplementary diagnostic test in the diagnostic process of CRC and other serious bowel disease in individuals with non-alarm symptoms of CRC in general practice.

PMID:
30065255
DOI:
10.1038/s41416-018-0178-7

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