Diagnostic accuracy of the faecal immunochemical test for colorectal cancer in symptomatic patients: comparison with NICE and SIGN referral criteria. (August 2014)

• Record Type: Journal Article
• Authors: Cubiella, J.; Salve, M.; Díaz‐Ondina, M.; Vega, P.; Alves, M. T.; Iglesias, F.; Sánchez, E.; Macía, P.; Blanco, I.; Bujanda, L.; Fernández‐Seara, J.
• Is Part Of: Colorectal disease. Volume 16:Number 8(2014)
• Page Start: O273
• Page End: O282
• Publication Date: 2014-08
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12569
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12569-abs-0001"> <title>Abstract</title> <sec id="codi12569-sec-0001" sec-type="section"> <title>Aim</title> <p>The diagnostic accuracy of the faecal immunochemical test (FIT) at a 100 ng/ml threshold for colorectal cancer (CRC) was compared with National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) referral criteria.</p> </sec> <sec id="codi12569-sec-0002" sec-type="section"> <title>Method</title> <p>A multicentre, prospective, blind study of diagnostic tests was carried out in two Spanish health areas. In 787 symptomatic patients referred for a diagnostic colonoscopy, we determined whether patients met NICE and SIGN referral criteria. All patients performed one FIT determination (OCsensor<sup>™</sup>). The sensitivity and specificity for CRC detection were determined with McNemar's test. The diagnostic odds ratio as well as the number needed to scope (NNS) to detect a CRC were calculated.</p> </sec> <sec id="codi12569-sec-0003" sec-type="section"> <title>Results</title> <p>We detected CRC in 97 (12.3%) patients; 241 (30.6%) had an FIT ≥ 100 ng/ml and 300 (38.1%) and 473 (60.1%) met NICE and SIGN referral criteria. The FIT had a higher sensitivity for CRC detection than NICE criteria (87.6%, 61.9%; <italic>P </italic><<italic> </italic>0.001) and SIGN criteria (82.5%; <italic>P </italic>=<italic> </italic>0.4). The specificity of FIT was also higher than NICE and SIGN criteria (77.4%, 65.2%, 42.7%; <italic>P </italic><<italic> </italic>0.001). The odds ratios of FIT, NICE and SIGN criteria for the diagnosis of CRC were 24.24 (95% CI 12.91–45.53), 3.04 (95% CI 1.96–4.71) and 3.51 (95% CI 2.03–6.06). The NNS to detect a CRC in individuals with an FIT ≥ 100 ng/ml was 2.83 (95% CI 2.4–3.41) and in individuals who met NICE and SIGN criteria it was 5 (95% CI 3.98–6.37) and 5.95 (95% CI 4.85–7.35).</p> </sec> <sec id="codi12569-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our study suggests that FIT is more accurate for the detection of CRC than the current NICE and SIGN referral criteria in symptomatic patients referred for colonoscopy.</p> </sec> </abstract>