Abstract
Abstract Introduction Colorectal cancer (CRC) accounts for approximately 10% of all cancer diagnoses and 9.4% of all cancer deaths worldwide. Since its introduction, quantitative faecal immunochemical testing (qFIT) has become a vital tool in bowel cancer screening and triaging of symptomatic patients. Our trust has seen a 20% increase in lower gastrointestinal referrals over a 12-month period. The aim of this investigation was to identify how many patients with a negative qFIT were diagnosed with CRC within 12 months and if there is potential to downgrade referrals with negative qFIT. Methods This retrospective study reviewed new CRC diagnoses in one hospital trust, diagnosed from January to December 2022, who were referred as symptomatic red flag referrals. All patients in this timeframe had records reviewed for qFIT performed within the 12 months prior to their diagnosis. A negative qFIT test was defined as lab result of <7ugHb/g. Results Two hundred and forty-seven patients were diagnosed with CRC from January to December 2022. One hundred and three patients did not have a documented qFIT within the timeframe and therefore were excluded from analysis. One hundred and forty-four cases were further reviewed, of which 14 (9.7%) had a negative qFIT within the 12 months before diagnosis. Conclusions This audit does not support the downgrading of Red Flag referrals based on a negative qFIT result. Further analysis is needed to ascertain how best to triage symptomatic referrals for colorectal cancer with a negative qFIT to help cope with an increasing burden of Red Flag referrals.
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