Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

Robert JC Steele; Paula J McDonald; Jayne Digby; Linda Brownlee; Judith A Strachan; Gillian Libby; Paula L McClements; Janice Birrell; Francis A Carey; Robert H Diament; Margaret Balsitis; Callum G Fraser

doi:10.1177/2050640613489281

Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

Robert JC Steele, Paula J McDonald, Jayne Digby, Linda Brownlee, Judith A Strachan, Gillian Libby, Paula L McClements, Janice Birrell, Francis A Carey, Robert H Diament, Margaret Balsitis, Callum G Fraser

Research output: Contribution to journal › Article › peer-review

67 Citations (Scopus)

Abstract

Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.
Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.
Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.
Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.

Original language	English
Pages (from-to)	198-205
Number of pages	8
Journal	United European Gastroenterology Journal
Volume	1
Issue number	3
Early online date	7 May 2013
DOIs	https://doi.org/10.1177/2050640613489281
Publication status	Published - Jun 2013

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10.1177/2050640613489281

An analysis of the utility of quantitative faecal immunochemical tests in screening and symptomatic populations
McDonald, P. J. (Author), Steele, R. (Supervisor) & Bartlett, W. (Supervisor), 2016
Student thesis: Doctoral Thesis › Doctor of Philosophy

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The relationship between faecal haemoglobin concentration and risk of significant colorectal neoplasia in screening and symptomatic populations.
Digby, J. (Author), Steele, R. (Supervisor) & Fraser, C. (Supervisor), 2016
Student thesis: Doctoral Thesis › Doctor of Philosophy

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Steele, R. JC., McDonald, P. J., Digby, J., Brownlee, L., Strachan, J. A., Libby, G., McClements, P. L., Birrell, J., Carey, F. A., Diament, R. H., Balsitis, M., & Fraser, C. G. (2013). Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity. United European Gastroenterology Journal, 1(3), 198-205. https://doi.org/10.1177/2050640613489281

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title = "Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity",

abstract = "Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.",

author = "Steele, {Robert JC} and McDonald, {Paula J} and Jayne Digby and Linda Brownlee and Strachan, {Judith A} and Gillian Libby and McClements, {Paula L} and Janice Birrell and Carey, {Francis A} and Diament, {Robert H} and Margaret Balsitis and Fraser, {Callum G}",

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doi = "10.1177/2050640613489281",

language = "English",

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Steele, RJC, McDonald, PJ, Digby, J, Brownlee, L, Strachan, JA, Libby, G, McClements, PL, Birrell, J, Carey, FA, Diament, RH, Balsitis, M & Fraser, CG 2013, 'Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity', United European Gastroenterology Journal, vol. 1, no. 3, pp. 198-205. https://doi.org/10.1177/2050640613489281

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T1 - Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

AU - Steele, Robert JC

AU - McDonald, Paula J

AU - Digby, Jayne

AU - Brownlee, Linda

AU - Strachan, Judith A

AU - Libby, Gillian

AU - McClements, Paula L

AU - Birrell, Janice

AU - Carey, Francis A

AU - Diament, Robert H

AU - Balsitis, Margaret

AU - Fraser, Callum G

PY - 2013/6

Y1 - 2013/6

N2 - Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.

AB - Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.

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DO - 10.1177/2050640613489281

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SN - 2050-6406

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JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

IS - 3

ER -

Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

Abstract

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Student theses

An analysis of the utility of quantitative faecal immunochemical tests in screening and symptomatic populations

The relationship between faecal haemoglobin concentration and risk of significant colorectal neoplasia in screening and symptomatic populations.

Cite this