期刊
ANNALS OF CLINICAL BIOCHEMISTRY
卷 58, 期 3, 页码 211-219出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0004563220985547
关键词
Colorectal cancer; colorectal disease; faecal biomarkers; faecal immunochemical test; faecal haemoglobin; primary care
资金
- Detect Cancer Early initiative (Scottish Government)
- Chief Scientist Office
This study examined the clinical outcomes of using f-Hb for CRC risk assessment in primary care, showing that decisions on reassurance or further investigation could be made based on different f-Hb thresholds. However, for patients with iron deficiency anemia, severe symptoms, or persistent symptoms, further investigation should not be denied.
Background Faecal haemoglobin concentration (f-Hb), estimated using a faecal immunochemical test, can be safely implemented in primary care to assess risk of colorectal cancer (CRC). Clinical outcomes of patients presenting with symptoms of lower gastrointestinal disease were examined using an extensive range of f-Hb thresholds to decide on reassurance or referral for further investigation. Methods All patients who attended primary care and submitted a single faecal specimen faecal immunochemical test in the first year of the routine service had f-Hb estimated using HM-JACKarc: f-Hb thresholds from <2 to >= 400 mu g Hb/g faeces (mu g/g) were examined. Results Low f-Hb thresholds of <2, <7, <10 and <20 mu g/g gave respective CRC risks of 0.1, 0.3, 0.3 and 0.4%, numbers needed to scope for one CRC of 871, 335, 300 and 249, and 'false negative' rates of 2.9, 11.4, 13.3 and 17.1%. With thresholds of <2, <7, <10 and <20 mu g/g, 48.6, 74.6, 78.1 and 83.2% respectively of symptomatic patients could be managed without further investigation. With reassurance thresholds of <2 mu g/g, <7 mu g/g and <10 mu g/g, the thresholds for referral for urgent investigation would be >400 mu g/g, >= 200 mu g/g and >= 100 mu g/g. However, patients with a f-Hb concentration of <10 or <20 mu g/g with iron deficiency anaemia, or with severe or persistent symptoms, should not be denied further investigation. Conclusions In primary care, f-Hb, in conjunction with clinical assessment, can safely and objectively determine individual risk of CRC and decide on simple reassurance or urgent, or routine referral.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据