Abstract
BackgroundThere has been interest in using the non-invasive, home-based quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients.AimTo elicit public preferences for FIT versus colonoscopy (CC) and its delivery in primary care.Design & settingA cross-sectional online survey in England.MethodA total of 1057 adults (without CRC symptoms and diagnosis) aged 40–59 years were invited from an English online survey panel. Responders were asked to imagine they had been experiencing CRC symptoms that would qualify them for a diagnostic test. Participants were presented with choices between CC and FIT in ascending order of number of CRCs missed by FIT (from 1–10%). It was measured at what number of missed CRCs responders preferred CC over FIT.ResultsWhile 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred FIT to CC at that level of accuracy. However, this preference reduced to 427 (40.4%) when FIT missed one additional cancer. Women were more likely to tolerate missing CRC when using FIT. Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%).ConclusionWhile the majority of participants preferred FIT over CC when both tests had the same sensitivity, tolerance for missed CRCs was low.
Highlights
colorectal cancer (CRC) is the fourth most common cancer in the UK and the second biggest cause of cancer deaths.[1]
While 150 participants did not want either of the tests when both missed 1% CRCs, the majority (n = 741, 70.0%) preferred faecal immunochemical test (FIT) to CC at that level of accuracy
Having lower numeracy and perceiving a higher level of risk meant participants were less likely to tolerate a false negative test. Most of those who chose FIT preferred to return it by mail (62.2%), to be informed about normal test results by letter (42.1%), and about abnormal test results face to face (32.5%)
Summary
CRC is the fourth most common cancer in the UK and the second biggest cause of cancer deaths.[1] The majority of CRCs are still diagnosed among symptomatic patients when outcomes tend to be worse in terms of survival.[2,3] There is strong impetus to promote early symptomatic presentation and prompt referral. One of the biggest barriers to prompt diagnosis is that symptoms of CRC are common and non-specific. CRC symptoms regarded as high-risk, such as rectal bleeding, only have a 3–4% positive predictive value. There has been interest in using the non-invasive, home-b ased quantitative faecal immunochemical test (FIT) to rule out colorectal cancer (CRC) in high-risk symptomatic patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
