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Qualitative faecal immunochemical tests (FITs) for diagnosing colorectal cancer in patients with histories of rectal bleeding in primary care: a cohort study
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.ORCID-id: 0000-0001-8846-7681
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. (Clister)ORCID-id: 0000-0002-3806-2114
Department of Clinical Sciences, Lund University, Malmö, Sweden. Department of R & D, Region Kronoberg, Växjö, Sweden..
Department of Clinical Sciences, Lund University, Malmö, Sweden. Department of R & D, Region Kronoberg, Växjö, Sweden. Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden..
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2020 (Engelska)Ingår i: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 35, nr 11, s. 2035-2040Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Rectal bleeding is considered an alarm symptom for colorectal cancer (CRC) but it is common and mostly caused by benign conditions. Qualitative faecal immunochemical tests (FITs) for occult blood have been used as diagnostic aids for many years in Sweden when CRC is suspected. The study aimed to evaluate the usefulness of FITs requested by primary care physicians for patients with and without histories of rectal bleeding, in the diagnosis of CRC.

METHODS: Results of all FITs requested in primary care for symptomatic patients in the Örebro region during 2015 were retrieved. Data on each patient's history of rectal bleeding was gathered from electronic health records. Patients diagnosed with CRC within 2 years were identified from the Swedish Cancer Register. The analysis focused on three-sample FITs, the customary FIT in Sweden.

RESULTS: A total of 4232 patients provided three-sample FITs. Information about the presence/absence of rectal bleeding was available for 2027 patients, of which 59 were diagnosed with CRC. For 606 patients with the presence of rectal bleeding, the FIT showed sensitivity 96.2%, specificity 60.2%, positive predictive value 9.8% (95% CI 6.1-13.4) and negative predictive value 99.7% (95% CI 99.2-100) for CRC. For 1421 patients without rectal bleeding, the corresponding figures were 100%, 73.6%, 8.3% (95% CI 5.6-10.9) and 100% (95% CI 99.6-100).

CONCLUSION: The diagnostic performance of a qualitative three-sample FIT provided by symptomatic patients in primary care was similar for those with and without a history of rectal bleeding. FITs seem useful for prioritising patients also with rectal bleeding for further investigation.

Ort, förlag, år, upplaga, sidor
Springer, 2020. Vol. 35, nr 11, s. 2035-2040
Nyckelord [en]
Colorectal neoplasms, Faecal immunochemical tests, Occult blood, Primary health care, Rectal bleeding
Nationell ämneskategori
Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:umu:diva-173259DOI: 10.1007/s00384-020-03672-1ISI: 000544184800001PubMedID: 32602056Scopus ID: 2-s2.0-85087126851OAI: oai:DiVA.org:umu-173259DiVA, id: diva2:1450315
Forskningsfinansiär
Cancerforskningsfonden i Norrland, LP 17-2168, LP 20-2231
Anmärkning

Grant supportJLL-758141, JLL-865141, JLL-930237/Region Jämtland HärjedalenLP 17-2168, LP 20-2231/Cancer Research Foundation in Northern Sweden

Tillgänglig från: 2020-07-01 Skapad: 2020-07-01 Senast uppdaterad: 2023-03-23Bibliografiskt granskad

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Högberg, CeciliaGunnarsson, UlfLilja, Mikael

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