Clinical Edge Journal Scan

Diagnostic efficacy of fecal immunochemical tests for assessment of suspected symptomatic CRC in primary care


 

Key clinical point: Implementation of fecal immunochemical tests (FIT) as a triage test during assessment of suspected symptomatic colorectal cancer (CRC) in primary care may improve the efficiency of referrals without missing cases of CRC.

Major finding: At a cutoff value of fecal hemoglobin (f-Hb) 150 μg Hb/g or higher, FIT identified more than half of CRC cases using few resources (sensitivity, 64.1%; specificity, 95.0%), whereas an f-Hb threshold of 20 μg Hb/g feces ruled out more than 85% of CRC (specificity, 86.6%; sensitivity 84.1%) at an expected prevalence of 1%-3%.

Study details: Findings are from a systematic review and meta-analysis of 22 studies including 69,536 symptomatic patients who consulted for abdominal symptoms in primary care.

Disclosures: This study was financed by Spain’s Carlos III Health Care Institute. The authors declared no conflicts of interest.

Source: Pin-Vieito N et al. Gut. 2021 Jun 9. doi: 10.1136/gutjnl-2021-324856 .

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