Faecal Immunochemical Test (FIT) Sensitivity - A Five Year Audit

Q: What was the purpose of the five-year audit of FIT?

To assess the diagnostic sensitivity of the faecal immunochemical test (FIT) in all patients diagnosed with colorectal cancer in Hull and East Yorkshire over a five-year period.

Q: How were FIT tests performed and how was colorectal cancer diagnosed?

FIT was performed using a HM-JACKarc analyser. Colorectal cancer was diagnosed using histological biopsy following colonoscopy as the gold standard.

Q: What sensitivity did FIT show in patients identified with colorectal cancer?

FIT sensitivity was reported as 92.00% based on the patients identified with colorectal cancer in the audit.

Sep 21, 2026

Upload by Violet

Retrospective audit assessed faecal immunochemical test (FIT) sensitivity for colorectal cancer using symptomatic patients in Hull and East Riding of Yorkshire, UK, across 2018–2022. FIT results were generated with a HM-JACKarc analyser and colorectal cancer diagnosis relied on histological biopsy after colonoscopy. Among 56,202 FITs, 1,511 cancers were identified; only 450 had a FIT within 12 months. Thirty-six FITs had concentrations <10 μg/g and yielded potential false negatives, producing an overall sensitivity of 92.00%.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Materials and Methods

Results

Discussion

Conclusion

BIOMEDICAL SCIENCE IN BRIEF published: 29 May 2024 doi: 10.3389/bjbs.2024.12862 *Correspondence Mark O. R. Hajjawi, [mark.hajjawi@nhs.net](mark.hajjawi@nhs.net) Received: 18 February 2024 Accepted: 09 May 2024 Published: 29 May 2024 Citation: Cole E, Narayanan D, Tiam RN, Shepherd J and Hajjawi MOR (2024) Faecal Immunochemical Test (FIT) Sensitivity; A Five Year Audit. Br J Biomed Sci 81:12862. doi: 10.3389/bjbs.2024.12862 Faecal Immunochemical Test (FIT) Sensitivity; A Five Year Audit Eddie Cole 1, Deepa Narayanan 2, Ree Nee Tiam 3, John Shepherd 1 and Mark O. R. Hajjawi 1 * 1Blood Sciences Department, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, United Kingdom, 2Clinical Biochemistry Department, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom, 3Cellular Pathology Department, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom Introduction: Colorectal cancer has a high prevalence and mortality rate in the United Kingdom. Cancerous colorectal lesions often bleed into the gastrointestinal lumen. The faecal immunochemical test (FIT) detects haemoglobin (Hb) in the faeces of patients and is used as a ﬁrst line test in the diagnosis of colorectal cancer. Materials and Methods: A retrospective audit of all FIT performed and all colorectal cancers diagnosed in the Hull and East Riding of Yorkshire counties of the United Kingdom (population approximately 609,300) between 2018 and 2022 was conducted. FIT were performed using a HM-JACKarc analyser from Kyowa medical. The predominant symptom suggestive of colorectal cancer which prompted the FIT was recorded. Colorectal cancer was diagnosed using the gold standard of histological biopsy following colonoscopy. Results: Between 2018 and 2022, 56,202 FIT were performed on symptomatic patients. Follow on testing identiﬁed 1,511 with colorectal cancer. Of these people, only 450 people with a conﬁrmed colorectal cancer had a FIT within the 12 months preceding their diagnosis. Of these 450 FIT results, 36 had a concentration of < 10 μg/g and may be considered to be a false negative. The sensitivity of FIT in the patientsidentiﬁed was 92.00%. The most common reason stated by the clinician for a FIT being performed in patients with colorectal cancer was a change in bowel habits, followed by iron deﬁcient anaemia. The number of patients diagnosed with colorectal cancer decreased in 2020, but increased signiﬁcantly in 2021 . Discussion: This study shows that 8.00% of people diagnosed with colorectal cancer in the Hull and East Riding of Yorkshire regions had a negative FIT. This study also shows that the SARS-CoV-2 pandemic affected the number of people diagnosed with colorectal cancer, and therefore skews the prevalence and pre-test probability of a positive test. There are many reasons why a FIT could produce a false negative result, the most likely being biological factors affecting the stability of haemoglobin within the gastrointestinal tract, or pre-analytical factors inﬂuencing faecal sampling preventing the detection of haemoglobin. Some colorectal lesions do not protrude into the gastrointestinal lumen and are less likely to bleed. Conclusion: This is the ﬁrst study showing data from outside of a structured clinical trial and provides the largest study to date showing the sensitivity of FIT in a routine clinical setting. This study also provides evidence for the impact COVID-19 had on the rate of colorectal cancer diagnosis. Keywords: colorectal cancer, FIT, faecal immunochemical test, sensitivity, bowel cancer, COVID-19, SARS-CoV- 2, intestine British Journal of Biomedical Science | Published by Frontiers 1 May 2024 | Volume 81 | Article 12862 INTRODUCTION Colorectal cancer is the fourth most common cancer in the United Kingdom [1] . This accounts for more than 40,000 new cases and almost 17,000 deaths [1] . Colorectal cancer also poses asigniﬁcant ﬁnancial burden to the United Kingdom,

FAQs

What was the purpose of the five-year audit of FIT?

To assess the diagnostic sensitivity of the faecal immunochemical test (FIT) in all patients diagnosed with colorectal cancer in Hull and East Yorkshire over a five-year period.

How were FIT tests performed and how was colorectal cancer diagnosed?

FIT was performed using a HM-JACKarc analyser. Colorectal cancer was diagnosed using histological biopsy following colonoscopy as the gold standard.

What sensitivity did FIT show in patients identified with colorectal cancer?

FIT sensitivity was reported as 92.00% based on the patients identified with colorectal cancer in the audit.

Sep 21, 2026

Upload by Violet