Aims Guaiac faecal occult blood tests are being replaced by faecal immunochemical tests (FIT). We investigated whether faecal haemoglobin concentration (f-Hb) was related to stage in progression of colorectal neoplasia, studying cancer and adenoma characteristics in an evaluation of quantitative FIT as a first-line screening test.
Methods We invited 66 225 individuals aged 50-74 years to provide one sample of faeces. f-Hb was measured on samples from 38 720 responders. Colonoscopy findings and pathology data were collected on the 943 with f-Hb >= 400 ng Hb/ml (80 mu g Hb/g faeces).
Results Of the 814 participants with outcome data (median age: 63 years, range 50-75, 56.4% male), 39 had cancer, 190 high-risk adenoma (HRA, defined as >= 3 or any >= 10 mm) and 119 low-risk adenoma (LRA). 74.4% of those with cancer had nf-Hb> 1000 ng Hb/ml compared with 58.4% with HRA, and 44.1% with no pathology. Median f-Hb concentration was higher in those with cancer than those with no (p10 mm) compared with small adenoma (p
Conclusions f-Hb is related to severity of colorectal neoplastic disease. This has ramifications for the selection of the appropriate cut-off concentration adopted for bowel screening programmes.
- 3 ROUNDS
- OCCULT BLOOD-TEST
- CANCER SCREENING PILOT
An analysis of the utility of quantitative faecal immunochemical tests in screening and symptomatic populationsAuthor: Mcdonald, P. J., 2016
Supervisor: Steele, R. (Supervisor) & Bartlett, W. (External person) (Supervisor)
Student thesis: Doctoral Thesis › Doctor of PhilosophyFile