The value of using the faecal immunochemical test in general
practice on patients presenting with non-alarm symptoms of colorectal
cancer

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Around 50% of individuals with colorectal cancer (CRC) initially present with non-alarm symptoms.

Methods

We investigated the value of using the faecal immunochemical test (FIT) in the diagnostic process of CRC and other serious bowel disease in individuals presenting with non-alarm symptoms in general practice. The study was conducted in the Central Denmark Region from 1 September 2015 to 30 August 2016. The FIT was used as a rule-in test on patients aged ≥30 years with non-alarm symptoms of CRC. The cut-off value was set to 10 µg Hb/g faeces.

Results

A total of 3462 valid FITs were performed. Of these, 540 (15.6%) were positive. Three months after FIT performance, 51 (PPV: 9.4% (95% CI: 7.0;11.9)) individuals with a positive FIT were diagnosed with CRC and 73 (PPV: 13.5% (95%CI: 10.6;16.4)) with other serious bowel disease. Of CRCs, 66.7% were diagnosed in UICC stage I & II and 19.6% in stage IV. The false negative rate for CRC was <0.1% for the initial 3 months after FIT performance.

Conclusion

The FIT may be used as a supplementary diagnostic test in the diagnostic process of CRC and other serious bowel disease in individuals with non-alarm symptoms of CRC in general practice.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: not found

Long-Term Mortality after Screening for Colorectal Cancer

Aasma Shaukat, Steven J Mongin, Mindy S Geisser … (2013)

In randomized trials, fecal occult-blood testing reduces mortality from colorectal cancer. However, the duration of the benefit is unknown, as are the effects specific to age and sex. In the Minnesota Colon Cancer Control Study, 46,551 participants, 50 to 80 years of age, were randomly assigned to usual care (control) or to annual or biennial screening with fecal occult-blood testing. Screening was performed from 1976 through 1982 and from 1986 through 1992. We used the National Death Index to obtain updated information on the vital status of participants and to determine causes of death through 2008. Through 30 years of follow-up, 33,020 participants (70.9%) died. A total of 732 deaths were attributed to colorectal cancer: 200 of the 11,072 deaths (1.8%) in the annual-screening group, 237 of the 11,004 deaths (2.2%) in the biennial-screening group, and 295 of the 10,944 deaths (2.7%) in the control group. Screening reduced colorectal-cancer mortality (relative risk with annual screening, 0.68; 95% confidence interval [CI], 0.56 to 0.82; relative risk with biennial screening, 0.78; 95% CI, 0.65 to 0.93) through 30 years of follow-up. No reduction was observed in all-cause mortality (relative risk with annual screening, 1.00; 95% CI, 0.99 to 1.01; relative risk with biennial screening, 0.99; 95% CI, 0.98 to 1.01). The reduction in colorectal-cancer mortality was larger for men than for women in the biennial-screening group (P=0.04 for interaction). The effect of screening with fecal occult-blood testing on colorectal-cancer mortality persists after 30 years but does not influence all-cause mortality. The sustained reduction in colorectal-cancer mortality supports the effect of polypectomy. (Funded by the Veterans Affairs Merit Review Award Program and others.).

0 comments Cited 297 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis.

Fausto Petrelli, Gianluca Tomasello, Karen Borgonovo … (2016)

Primary tumor location is emerging as an important prognostic factor owing to distinct biological features. However, the side of origin of colon cancer (CC) still does not represent a prognostic parameter when deciding for adjuvant or palliative chemotherapy.

0 comments Cited 265 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

General practice and primary health care in Denmark.

Kjeld Pedersen, John Andersen, Jens Søndergaard (2012)

General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized by 5 key components: (1) a list system, with an average of close to 1600 persons on the list of a typical GP; (2) the GP as gatekeeper and first-line provider in the sense that a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment; (3) an after-hours system staffed by GPs on a rota basis; (4) a mixed capitation and fee-for-service system; and (5) GPs are self-employed, working on contract for the public funder based on a national agreement that details not only services and reimbursement but also opening hours and required postgraduate education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges. Practice units are fairly small: close to 2 GPs per unit plus nurses and secretaries. The units are fully computerized, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies etc. Over the past few years a decrease in solo practices has been seen and is expected to accelerate, in part because of the GP age structure, with many GPs retiring and new GPs not wanting to practice alone. This latter workforce trend is pointing toward a new model with employed GPs, particularly in rural areas.

0 comments Cited 253 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Jakob Søgaard Juul: +45 8716 8537 , jsjuul.feap@outlook.dk

Journal

Journal ID (nlm-ta): Br J Cancer

Journal ID (iso-abbrev): Br. J. Cancer

Title: British Journal of Cancer

Publisher: Nature Publishing Group UK (London )

ISSN (Print): 0007-0920

ISSN (Electronic): 1532-1827

Publication date (Electronic): 1 August 2018

Publication date (Print): 14 August 2018

Volume: 119

Issue: 4

Pages: 471-479

Affiliations

[1 ]ISNI 0000 0001 1956 2722, GRID grid.7048.b, Department of Public Health, Research Unit for General Practice, , Aarhus University, ; Bartholins Allé 2, 8000 Aarhus C, Denmark

[2 ]ISNI 0000 0001 1956 2722, GRID grid.7048.b, Department of Public Health, Research Centre for Cancer Diagnosis in Primary Care, , Aarhus University, ; Bartholins Allé 2, 8000 Aarhus C, Denmark

[3 ]ISNI 0000 0004 0646 8878, GRID grid.415677.6, Department of Clinical Biochemistry, , Randers Regional Hospital, ; Skovlyvej 1, 8930 Randers, NE Denmark

[4 ]ISNI 0000 0004 0646 8878, GRID grid.415677.6, Department of Public Health Programmes, , Randers Regional Hospital, ; Skovlyvej 1, 8930 Randers, NE Denmark

[5 ]ISNI 0000 0004 0512 597X, GRID grid.154185.c, Department of Surgery, , Aarhus University Hospital, ; Tage Hansens Gade 2, 8000 Aarhus C, Denmark

[6 ]ISNI 0000 0001 1956 2722, GRID grid.7048.b, Department of Clinical Medicine, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, , Aarhus University, ; Aarhus C, Denmark

Article

Publisher ID: 178

DOI: 10.1038/s41416-018-0178-7

PMC ID: 6133998

PubMed ID: 30065255

SO-VID: fc5d167f-0fe8-45e3-b997-a40aab5bc305

License:

Note: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).

History

Date received : 12 December 2017

Date accepted : 18 June 2018

Funding

Funded by: FundRef https://doi.org/10.13039/100008363, Kræftens Bekæmpelse (Danish Cancer Society);

Award ID: R134-A8421-15-S42

Award Recipient : Jakob Søgaard Juul

Custom metadata

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: digestive signs and symptoms,colorectal cancer,diagnosis

Data availability:

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: digestive signs and symptoms, colorectal cancer, diagnosis

Comments

Comment on this article

scite_

Cited by 32

See all cited by

Most referenced authors 2,104

See all reference authors

- Version 1

The value of using the faecal immunochemical test in general practice on patients presenting with non-alarm symptoms of colorectal cancer

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Karger: Gastroenterology

Most cited references 31

Long-Term Mortality after Screening for Colorectal Cancer

Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis.

General practice and primary health care in Denmark.

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 166

Cited by 32

Most referenced authors 2,104