TU4.6 Comparison between the outcome of patient's with qFIT>120 and patients with qFIT<120.Can qFIT<120 be considered a negative test??

Abstract

IntroductionWhen FIT is used for symptomatic patients presenting to primary care a positive result is considered ≥10 mcgHb/gStool. When qFIT is used for the asymptomatic screening population (i.e NBCSP) a positive result is ≥120mcgHb/gStool.During covid-19 Pandemic the 120 cut off was used in some of the hospitals to triage patients who require further investigations for either colonoscopy or CT scan.MethodsRetrospective cohort study done in general district hospital comparing the pathology identified in patients with Qfit results>120 and patients with result <120.ResultsIn the period between July 2020 and November 2021, 448 patients had +ve qFIT result (≥10 micrograms).In the first group, 340 patients had qFIT result <120. 191 patients had colonoscopy with 8 confirmed colorectal cancer, and 137 patients had CT/CT colon with only 1 patient was found to have colorectal cancer. Overall 2.6% of the patients had cancer.While in the second group, 108 patients had qFIT>120. 69 patients had colonoscopy with 9 confirmed cancer. the rest of the patients had CT/CT colon with 2 patients showing features of malignancy. Overall 10.1% of the patients had cancer.ConclusionThe incidence of colorectal cancer in patients with qFIT result >120 is much higher than the other group, but the incidence of colorectal cancer in patients with qFIT<120 is still significant and the patients shouldn't be discharged without investigations.