Faecal immunochemical tests can improve colonoscopy triage in patients with iron deficiency: A systematic review and meta-analysis.
Crit Rev Oncol Hematol
; 201: 104439, 2024 Sep.
Article
de En
| MEDLINE
| ID: mdl-38977142
ABSTRACT
BACKGROUND:
Use of the faecal immunochemical test (FIT) to triage patients with iron deficiency (ID) for colonoscopy due to suspected colorectal cancer (CRC) may improve distribution of colonoscopic resources. We reviewed the diagnostic performance of FIT for detecting advanced colorectal neoplasia, including CRC and advanced pre-cancerous neoplasia (APCN), in patients with ID, with or without anaemia.METHODS:
We performed a systematic review of three databases for studies comprising of patients with ID, with or without anaemia, completing a quantitative FIT within six months prior to colonoscopy, where test performance was compared against the reference standard colonoscopy. Random effects meta-analyses determined the diagnostic performance of FIT for advanced colorectal neoplasia.RESULTS:
Nine studies were included on a total of n=1761 patients with ID, reporting FIT positivity thresholds between 4-150⯵g haemoglobin/g faeces. Only one study included a non-anaemic ID (NAID) cohort. FIT detected CRC and APCN in ID patients with 90.7â¯% and 49.3â¯% sensitivity, and 81.0â¯% and 82.4â¯% specificity, respectively. FIT was 88.0â¯% sensitive and 83.4â¯% specific for CRC in patients with ID anaemia at a FIT positivity threshold of 10⯵g haemoglobin/g faeces.CONCLUSIONS:
FIT shows high sensitivity for advanced colorectal neoplasia and may be used to triage those with ID anaemia where colonoscopic resources are limited, enabling those at higher risk of CRC to be prioritised for colonoscopy. There is a need for further research investigating the diagnostic performance of FIT in NAID patients.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs colorectales
/
Coloscopie
/
Anémie par carence en fer
/
Sang occulte
Limites:
Humans
Langue:
En
Journal:
Crit Rev Oncol Hematol
Sujet du journal:
HEMATOLOGIA
/
NEOPLASIAS
Année:
2024
Type de document:
Article
Pays de publication:
Pays-Bas