Publications
157 results found
Ahmad A, Moorghen M, Wilson A, et al., 2022, Implementation of optical diagnosis with a "resect and discard" strategy in clinical practice: DISCARD3 study, Gastrointestinal Endoscopy, Vol: 96, Pages: 1021-1032.e2, ISSN: 0016-5107
Background and AimsOptical diagnosis (OD) of polyps can be performed with advanced endoscopic imaging. For high-confidence diagnoses, a “resect and discard” strategy could offer significant histopathology time and cost savings. The implementation threshold is a ≥90% OD-histology surveillance interval concordance. Here we assessed the OD learning curve and feasibility of a resect and discard strategy for ≤5-mm and <10-mm polyps in a bowel cancer screening setting.MethodsIn this prospective feasibility study, 8 bowel cancer screening endoscopists completed a validated OD training module and performed procedures. All <10-mm consecutive polyps had white-light and narrow-band images taken and were given high- or low-confidence diagnoses until 120 high-confidence ≤5-mm polyp diagnoses had been performed. All polyps had standard histology. High-confidence OD errors underwent root-cause analysis. Histology and OD-derived surveillance intervals were calculated.ResultsOf 565 invited patients, 525 patients were included. A total of 1560 <10-mm polyps underwent OD and were resected and retrieved (1329 ≤5 mm and 231 6-9 mm). There were no <10-mm polyp cancers. High-confidence OD was accurate in 81.5% of ≤5-mm and 92.8% of 6-9-mm polyps. Sensitivity for OD of a ≤5-mm adenoma was 93.0% with a positive predictive value of 90.8%. OD-histology surveillance interval concordance for ≤5-mm OD was 91.3% (209/229) for U.S. Multi-Society Task Force, 98.3% (225/229) for European Society of Gastrointestinal Endoscopy, and 98.7% (226/229) for British Society of Gastroenterology guidelines, respectively.ConclusionsA resect and discard strategy for high-confidence ≤5-mm polyp OD in a group of bowel cancer screening colonoscopists is feasible and safe, with performance exceeding the 90% surveillance interval concordance required for implementation in clinical practice. (Clinical trial registration number: NCT04710693.)
Monahan K, 2022, Exploring the utility and acceptability of Faecal Immunochemical Testing (FIT) as a novel intervention for the improvement of Colorectal Cancer (CRC) surveillance in individuals with Lynch Syndrome: A single-arm, prospective, multi-centre, non- randomised study, BMC Cancer, Vol: 22, Pages: 1-11, ISSN: 1471-2407
BackgroundLynch Syndrome (LS) is an inherited cancer predisposition syndrome defined by pathogenic variants in the mismatch repair (MMR) or EPCAM genes. In the United Kingdom, people with LS are advised to undergo biennial colonoscopy from as early as 25 until 75 years of age to mitigate a high lifetime colorectal cancer (CRC) risk, though the consideration of additional surveillance intervention(s) through the application of non-invasive diagnostic devices has yet to be longitudinally observed in LS patients. In this study, we will examine the role of annual faecal immunochemical testing (FIT) alongside biennial colonoscopy for CRC surveillance in people with LS.Methods/designIn this single-arm, prospective, non-randomised study, 400 LS patients will be recruited across 11 National Health Service (NHS) Trusts throughout the United Kingdom. Study inclusion requires a LS diagnosis, between 25 and 73 years old, and a routine surveillance colonoscopy scheduled during the recruitment period. Eligible patients will receive a baseline OC-Sensor™ FIT kit ahead of their colonoscopy, and annually for 3 years thereafter. A pre-paid envelope addressed to the central lab will be included within all patient mailings for the return of FIT kits and relevant study documents. A questionnaire assessing attitudes and perception of FIT will also be included at baseline. All study samples received by the central lab will be assayed on an OC-Sensor™ PLEDIA Analyser. Patients with FIT results of ≥6 μg of Haemoglobin per gram of faeces (f-Hb) at Years 1 and/or 3 will be referred for colonoscopy via an urgent colonoscopy triage pathway.16S rRNA gene V4 amplicon sequencing will be carried out on residual faecal DNA of eligible archived FIT samples to characterise the faecal microbiome.DiscussionFIT may have clinical utility alongside colonoscopic surveillance in people with LS. We have designed a longitudinal study to examine the efficacy of FIT
Woodfield G, Belluomo I, Laponogov I, et al., 2022, Diagnostic performance of a non-invasive breath test for colorectal cancer: COBRA1 study, Gastroenterology, Vol: 163, Pages: 1447-1449.e8, ISSN: 0016-5085
Moller P, Seppala T, Dowty JG, et al., 2022, Colorectal cancer incidences in Lynch syndrome: a comparison of results from the prospective lynch syndrome database and the international mismatch repair consortium, Hereditary Cancer in Clinical Practice, Vol: 20, Pages: 1-11, ISSN: 1731-2302
ObjectiveTo compare colorectal cancer (CRC) incidences in carriers of pathogenic variants of the MMR genes in the PLSD and IMRC cohorts, of which only the former included mandatory colonoscopy surveillance for all participants.MethodsCRC incidences were calculated in an intervention group comprising a cohort of confirmed carriers of pathogenic or likely pathogenic variants in mismatch repair genes (path_MMR) followed prospectively by the Prospective Lynch Syndrome Database (PLSD). All had colonoscopy surveillance, with polypectomy when polyps were identified. Comparison was made with a retrospective cohort reported by the International Mismatch Repair Consortium (IMRC). This comprised confirmed and inferred path_MMR carriers who were first- or second-degree relatives of Lynch syndrome probands.ResultsIn the PLSD, 8,153 subjects had follow-up colonoscopy surveillance for a total of 67,604 years and 578 carriers had CRC diagnosed. Average cumulative incidences of CRC in path_MLH1 carriers at 70 years of age were 52% in males and 41% in females; for path_MSH2 50% and 39%; for path_MSH6 13% and 17% and for path_PMS2 11% and 8%. In contrast, in the IMRC cohort, corresponding cumulative incidences were 40% and 27%; 34% and 23%; 16% and 8% and 7% and 6%. Comparing just the European carriers in the two series gave similar findings. Numbers in the PLSD series did not allow comparisons of carriers from other continents separately. Cumulative incidences at 25 years were < 1% in all retrospective groups.ConclusionsProspectively observed CRC incidences (PLSD) in path_MLH1 and path_MSH2 carriers undergoing colonoscopy surveillance and polypectomy were higher than in the retrospective (IMRC) series, and were not reduced in path_MSH6 carriers. These findings were the opposite to those expected. CRC point incidence before 50 years of age was reduced in path_PMS2 carriers subjected to colonoscopy, but not significantly so.
, 2022, InSiGHT 2022 Abstract Publishing and Best Abstract Awards Abstracts, FAMILIAL CANCER, Vol: 21, Pages: 557-636, ISSN: 1389-9600
Daca-Alvarez M, Marti M, Spinelli A, et al., 2022, Familial component of early-onset colorectal cancer: opportunity for prevention, BRITISH JOURNAL OF SURGERY, Vol: 109, Pages: 1319-1325, ISSN: 0007-1323
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Monahan KJ, Davies MM, Abulafi M, et al., 2022, Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG), Gut, Vol: 71, Pages: 1939-1962, ISSN: 0017-5749
Faecal immunochemical testing (FIT) has a high sensitivity for the detection of colorectal cancer (CRC). In a symptomatic population FIT may identify those patients who require colorectal investigation with the highest priority. FIT offers considerable advantages over the use of symptoms alone, as an objective measure of risk with a vastly superior positive predictive value for CRC, while conversely identifying a truly low risk cohort of patients. The aim of this guideline was to provide a clear strategy for the use of FIT in the diagnostic pathway of people with signs or symptoms of a suspected diagnosis of CRC. The guideline was jointly developed by the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology, specifically by a 21-member multidisciplinary guideline development group (GDG). A systematic review of 13 535 publications was undertaken to develop 23 evidence and expert opinion-based recommendations for the triage of people with symptoms of a suspected CRC diagnosis in primary care. In order to achieve consensus among a broad group of key stakeholders, we completed an extended Delphi of the GDG, and also 61 other individuals across the UK and Ireland, including by members of the public, charities and primary and secondary care. Seventeen research recommendations were also prioritised to inform clinical management.
Edwards P, Monahan KJ, 2022, Diagnosis and management of Lynch syndrome, Frontline Gastroenterology, Vol: 13, Pages: e80-e87, ISSN: 2041-4137
Lynch syndrome (LS) is a dominantly inherited cancer susceptibility syndrome defined by presence of pathogenic variants in DNA mismatch repair genes MLH1, MSH2, MSH6 and PMS2, or in deletions of the EPCAM gene. Although LS is present in about 1 in 400 people in the UK, it estimated that only 5% of people with this condition are aware of the diagnosis. Therefore, testing for LS in all new diagnoses of colorectal or endometrial cancers is now recommended in the UK, and gastroenterologists can offer ‘mainstreamed’ genetic testing for LS to patients with cancer. Because LS results in a high lifetime risk of colorectal, endometrial, gastric, ovarian, hepatobiliary, brain and other cancers, the lifelong care of affected individuals and their families requires a coordinated multidisciplinary approach. Interventions such as high-quality 2-yearly colonoscopy, prophylactic gynaecological surgery, and aspirin are proven to prevent and facilitate early diagnosis and prevention of cancers in this population, and improve patient outcomes. Recently, an appreciation of the mechanism of carcinogenesis in LS-associated cancers has contributed to the development of novel therapeutic and diagnostic approaches, with a gene-specific approach to disease management, with potential cancer-preventing vaccines in development. An adaptive approach to surgical or oncological management of LS-related cancers may be considered, including an important role for novel checkpoint inhibitor immunotherapy in locally advanced or metastatic disease. Therefore, a personalised approach to lifelong gene-specific management for people with LS provides many opportunities for cancer prevention and treatment which we outline in this review.
Lincoln AG, Benton SC, Sasieni P, et al., 2022, Risk-stratified FIT for urgent colonoscopy in Lynch syndrome: A clinical service throughout the COVID-19 pandemic., Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
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Lincoln AG, Benton SC, Sasieni P, et al., 2022, Risk-stratified FIT for urgent colonoscopy in Lynch syndrome: A clinical service throughout the COVID-19 pandemic., Publisher: American Society of Clinical Oncology (ASCO), Pages: 10606-10606, ISSN: 0732-183X
<jats:p> 10606 </jats:p><jats:p> Background: Lynch syndrome (LS) is an inherited disorder characterized by pathogenic variants within mismatch repair genes resulting in an increased risk of colorectal cancer (CRC). In England, the fecal immunochemical test for Haemoglobin (FIT) is currently used in non-LS symptomatic and screening populations to guide subsequent colonoscopy. Herein, we report results from a national emergency clinical service implemented during the COVID-19 pandemic which used FIT to prioritize colonoscopy in LS patients while endoscopy services were limited. Methods: Regional genetic and endoscopy services across England were invited to participate. Patient eligibility was determined by 1) Diagnosis of Lynch Syndrome 2) Planned colonoscopic surveillance between 1 March 2020 and 31 March 2021. Requests for FIT testing from participating NHS Trusts were sent to the NHS Bowel Cancer Screening South of England Hub’s Research Laboratory in Surrey. The Hub sent patients a FIT kit (OC-Sensor™ (Eiken, Japan)), instructions for use, a questionnaire, and a pre-paid return envelope. Lab reports with feecal haemoglobin (f-Hb) results were returned electronically for clinical action. LS patients were risk-stratified for colonoscopy based upon the following f-Hb thresholds: (1) f-Hb ≥10µg of Haemoglobin (Hb)/g (µg/g) faeces: triaged for colonoscopy via an urgent two-week wait (2WW) pathway, (2) f-Hb ≤10µg/g: schedule patients for colonoscopy within 6-12 weeks, where local endoscopy service availability permits. Results: Fifteen centers across England participated in the clinical service from 9<jats:sup>th</jats:sup> June 2020 to 31<jats:sup>st</jats:sup> March 2021. An uptake rate of 64% was observed from this cohort (375/588 invites), though 21 cases were removed from analysis due to repeat FITs, insufficient sample, missing clinical data, or FIT completed after colonoscopy. Of the re
Ahmad A, Moorghen M, Wilson A, et al., 2022, LEARNING CURVE FOR OPTICAL DIAGNOSIS OF SMALL POLYPS AT SCREENING COLONOSCOPY (DISCARD3), Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A106-A106, ISSN: 0017-5749
Morley O, Mavrou A, Pawa N, et al., 2022, POST-COLORECTAL CANCER RESECTION COLONOSCOPY: FACTORS ASSOCIATED WITH COMPLIANCE, Publisher: BMJ PUBLISHING GROUP, Pages: A152-A153, ISSN: 0017-5749
Ahmad A, Moorghen M, Wilson A, et al., 2022, OPTICAL DIAGNOSIS OF POLYPS <10MM AND IMPACT ON SURVEILLANCE INTERVAL (DISCARD3), Publisher: BMJ PUBLISHING GROUP, Pages: A30-A30, ISSN: 0017-5749
Perea J, Corchete LA, Monahan KJ, et al., 2022, 1144: EARLY-ONSET COLORECTAL CANCER: GEOGRAPHICAL DISPARITIES ACCORDING TO PHENOTYPE, Publisher: Elsevier BV, Pages: S-269, ISSN: 0016-5085
Perea J, Corchete LA, Monahan KJ, et al., 2022, EARLY-ONSET COLORECTAL CANCER: GEOGRAPHICAL DISPARITIES ACCORDING TO PHENOTYPE, Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S269-S269, ISSN: 0016-5085
Llach J, Pellise M, Monahan K, 2022, Lynch syndrome; towards more personalized management?, BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, Vol: 58-59, ISSN: 1521-6918
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Loong L, Cubuk C, Choi S, et al., 2022, Quantifying prediction of pathogenicity for within-codon concordance (PM5) using 7541 functional classifications of BRCA1 and MSH2 missense variants, Genetics in Medicine, Vol: 24, Pages: 552-563, ISSN: 1098-3600
PURPOSE: Conditions and thresholds applied for evidence weighting of within-codon concordance (PM5) for pathogenicity vary widely between laboratories and expert groups. Because of the sparseness of available clinical classifications, there is little evidence for variation in practice. METHODS: We used as a truthset 7541 dichotomous functional classifications of BRCA1 and MSH2, spanning 311 codons of BRCA1 and 918 codons of MSH2, generated from large-scale functional assays that have been shown to correlate excellently with clinical classifications. We assessed PM5 at 5 stringencies with incorporation of 8 in silico tools. For each analysis, we quantified a positive likelihood ratio (pLR, true positive rate/false positive rate), the predictive value of PM5-lookup in ClinVar compared with the functional truthset. RESULTS: pLR was 16.3 (10.6-24.9) for variants for which there was exactly 1 additional colocated deleterious variant on ClinVar, and the variant under examination was equally or more damaging when analyzed using BLOSUM62. pLR was 71.5 (37.8-135.3) for variants for which there were 2 or more colocated deleterious ClinVar variants, and the variant under examination was equally or more damaging than at least 1 colocated variant when analyzed using BLOSUM62. CONCLUSION: These analyses support the graded use of PM5, with potential to use it at higher evidence weighting where more stringent criteria are met.
Lincoln A, Benton SC, Sasieni P, et al., 2022, PTH-27 Risk-stratified FIT for urgent colonoscopy in Lynch Syndrome: A clinical service throughout the COVID-19 pandemic (vol 70, pg A184, 2021), GUT, Vol: 71, Pages: E3-E3, ISSN: 0017-5749
Ahmad A, Wilson A, Dhillon A, et al., 2021, NO SURVEILLANCE INTERVAL CHANGE WITH OPTICAL DIAGNOSIS OF SMALL POLYPS DURING BOWEL CANCER SCREENING COLONOSCOPY, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A51-A52, ISSN: 0017-5749
Mak S, Latchford A, Hawkins M, et al., 2021, DIAGNOSTIC YIELD OF CONSTITUTIONAL GENETIC TESTING IN PATIENTS WITH MULTIPLE COLORECTAL ADENOMAS (MCRA), Publisher: BMJ PUBLISHING GROUP, Pages: A16-A17, ISSN: 0017-5749
Ahmad A, Wilson A, Dhillon A, et al., 2021, SMALL POLYPS AT COLONOSCOPY AND THE NICE CLASSIFICATION: LIKELY CAUSES OF OPTICAL DIAGNOSIS ERROR, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A47-A48, ISSN: 0017-5749
Ahmad A, Wilson A, Moorghen M, et al., 2021, OPTICAL DIAGNOSIS OF SMALL POLYPS AT COLONOSCOPY VERSUS HISTOPATHOLOGY: MOVING TOWARDS A NEW GOLD STANDARD?, Publisher: BMJ PUBLISHING GROUP, Pages: A28-A29, ISSN: 0017-5749
Ahmad A, Wilson A, Thomas-Gibson S, et al., 2021, LEARNING CURVE OF OPTICAL DIAGNOSIS WITH A RESECT AND DISCARD STRATEGY FOR SCREENING COLONOSCOPY, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A48-A48, ISSN: 0017-5749
Ahmad A, Wilson A, Thomas-Gibson S, et al., 2021, PATIENT ACCEPTABILITY OF DIMINUTIVE POLYP OPTICAL DIAGNOSIS WITH RESECT AND DISCARD STRATEGY IN SCREENING COLONOSCOPY, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A48-A49, ISSN: 0017-5749
Lincoln A, Lincoln A, Benton S, et al., 2021, RISK-STRATIFIED FIT FOR URGENT COLONOSCOPY IN LYNCH SYNDROME: A CLINICAL SERVICE THROUGHOUT THE COVID-19 PANDEMIC, Publisher: BMJ PUBLISHING GROUP, Pages: A184-A184, ISSN: 0017-5749
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Aggarwal N, Quaglia A, McPhail MJW, et al., 2021, Systematic review and meta-analysis of tumour microsatellite-instability status as a predictor of response to fluorouracil-based adjuvant chemotherapy in colorectal cancer, International Journal of Colorectal Disease: clinical and molecular gastroenterology and surgery, Vol: 37, Pages: 35-46, ISSN: 0179-1958
PurposeColorectal cancer (CRC) can be classified according to the chromosomal-instability pathway (a microsatellite-stable (MSS) pathway) and the microsatellite-instability (MSI) pathway. Adjuvant therapy after surgery in advanced CRC is usually based on fluoropyrimidine 5-fluorouracil (5-FU) alone or combined with other agents. Controversy however remains on the use of 5-FU-based regimens in treating MSI-related tumours.AimsTo systematically investigate the relationship between tumour microsatellite profile and 5-year overall survival in patients with CRC treated with 5-FU.MethodsA systematic literature review of PubMed and Embase databases was conducted. Pre-specified criteria determined study inclusion/exclusion. The PRISMA and QUADAS-2 criteria were used to assess study suitability and quality respectively. Patients were categorised as having either MSI or MSS CRC. Overall 5-year survival was estimated from Kaplan–Meier curves. Publication bias was assessed using funnel-plots and Egger’s test.Results1807 studies were identified, with meta-analysis performed using nine studies. 5-FU treated individuals with CRC who died at 5 years were found to be 0.31 times less likely to have MSI than those who were alive, although this was not statistically significant. There was an insufficient number of studies to enable subgroup analysis by stage.ConclusionsIn this meta-analysis, MSI status does not alter 5-year survival of patients with CRC patients treated with adjuvant 5-FU, however there is significant heterogeneity in the design of individual studies in the data synthesis. More studies are necessary to clarify whether CRC patients with MSI CRC, in particular early stage, should be offered 5-FU based adjuvant chemotherapy.
Ryan NAJ, Snowsill T, McKenzie E, et al., 2021, Should women with Lynch syndrome be offered gynaecological cancer surveillance?, BMJ, Vol: 374, Pages: 1-4, ISSN: 1759-2151
Alexander J, Johnston B, Smith T, et al., 2021, Low referral rates for genetic assessment of patients with multiple adenomas in United Kingdom Bowel Cancer Screening Programmes, Diseases of the Colon and Rectum, Vol: 64, Pages: 1058-1063, ISSN: 0012-3706
Background:Approximately one in twenty cases of colorectal cancer are caused by monogenic syndromes. Published guidelines recommend that patients with ten or more adenomas be referred for genetic testing, based on evidence that colorectal cancer risk is associated with adenoma multiplicity. Objective:The aim of this study was to determine adherence to guidelines on referral for genetic screening in patients with ten or more adenomas.Design:A cross-sectional study was performed of prospectively collected data from the United Kingdom Bowel Cancer Screening Program between May 2007 & June 2018. Only histologically confirmed adenomas were included. Clinicopathological data were recorded from patient records and referrals to clinical genetics services were ascertained. Setting:Data were obtained from three centres in London, United Kingdom.Patients:A total of 17,450 subjects underwent colonoscopy following an abnormal faecal occult blood test. Main outcome measures:We quantified patients with ten or more adenomas and the proportion referred for genetic screening.Results:The adenoma detection rate was 50.6% amongst 17,450 patients who underwent colonoscopy (8,831 had one or more adenomas). 347 patients (2.0%) had 10 or more adenomas. Patients with 10 or more adenomas were more likely to be male than those with less than 10 adenomas (76.9% vs. 53.4%; p<0.0001). A family history was collected in 37.8% of the multiple adenoma population. Of 347 patients with 10 or more adenomas, 28 (8.1%) were referred for genetic assessment.Limitations:All three screening centres were in a single city. No genetic outcome data were available to permit analysis of actual rates of inherited cancer syndromes in this population.Conclusions:In this study, almost one in fifty patients had ten or more adenomas. Despite guidelines advising genetic testing in this group, referral rates are low. A referral pathway and management strategies should be established to address this patient popula
D'Souza N, Monahan K, Benton SC, et al., 2021, Finding the needle in the haystack: the diagnostic accuracy of the faecal immunochemical test for colorectal cancer in younger symptomatic patients, Colorectal Disease, Vol: 23, Pages: 2539-2549, ISSN: 1462-8910
AimDetection of early onset colorectal cancer is challenging, and remains a rare diagnosis amongst younger people with gastrointestinal symptoms. We investigated whether faecal immunochemical testing (FIT) could identify younger patients at higher risk of colorectal cancer or serious bowel disease including colorectal cancer, inflammatory bowel disease or advanced adenomas.MethodsA subgroup analysis was performed of symptomatic patients under 50 years of age (<50) from the NICE FIT study, a multicentre, prospective diagnostic accuracy study of FIT conducted between October 2017 and December 2019. The diagnostic accuracy of FIT for colorectal cancer and serious bowel disease was investigated in younger patients at different faecal haemoglobin (f-Hb) cut-offs of 2, 10 and 150 µg blood/g faeces (µg/g).ResultsEarly onset colorectal cancer was diagnosed in 1.5% (16/1103) of younger symptomatic patients. The sensitivity of FIT for younger patients aged <50 was 87.5% (95% CI 61.7%–98.4%), 81.3% (54.4%–96.0%) and 68.8% (41.3%–89.0%) at f-Hb cut-offs of 2, 10 and 150 µg/g, respectively. The positive predictive value for colorectal cancer increased from 4.2% (2.3%–6.9%) to 11.5% (5.9%–19.6%) at cut-offs of 2 and 150 µg/g, while the positive predictive value for serious bowel disease increased from 31.3% (26.3%–36.5%) to 65.6% (55.2%–75.0%) at the same cut-offs. The negative predictive value of FIT for colorectal cancer remained above 99.5% at all cut-offs.ConclusionDetectable f-Hb on FIT in symptomatic younger patients may indicate referral for investigation of colorectal cancer and serious bowel disease.
D'Souza N, Delisle TG, Chen M, et al., 2021, Faecal immunochemical testing in symptomatic patients to prioritize investigation: diagnostic accuracy from NICE FIT Study, BRITISH JOURNAL OF SURGERY, Vol: 108, Pages: 804-810, ISSN: 0007-1323
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- Citations: 16
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