Faecal haemoglobin concentration is related to severity of colorectal neoplasia

Abstract

f-Hb is related to severity of colorectal neoplastic disease. This has ramifications for the selection of the appropriate cut-off concentration adopted for bowel screening programmes.

Second-Look Colonoscopies and the Impact on Capacity in FIT-Based Colorectal Cancer Screening

“…Advanced colorectal neoplasia is associated with a higher FIT Hb concentration, and accordingly a higher Hb concentration leads to a higher positive predictive value for AN (27)(28)(29)(30). Th ese results are consistent with our fi ndings and this readily explains the relation between a high fecal Hb concentration and the need for a secondlook colonoscopy.…”

Faecal haemoglobin concentration and personalised assessment of the risk of colorectal neoplasia

“…Research has explored many basic aspects concerning f-Hb and it has been shown that f-Hb rises with age and is higher in men than in women (7,8), and higher in the more socioeconomically deprived (8,9). It has been well documented that higher f-Hb is associated with a higher incidence of CRC and advanced adenoma, that is, advanced neoplasia (AN), because f-Hb is directly related to the severity of colorectal disease (10). Thus, it is hardly surprising that, if FITs are used as a simple qualitative dichotomous investigation with a single cut-off f-Hb applied to all participants, as is done in almost all current CRC screening programmes, as the f-Hb cut-off applied is increased, positivity rate, AN detection rate and sensitivity decrease, while specificity, positive predictive value and interval cancer proportion increase.…”

Setting up a service for a faecal immunochemical test for haemoglobin (FIT): a review of considerations, challenges and constraints

“…Added to this, when referral is made into secondary care following a positive FIT result, the quantitative result may allow those with elevated f-Hb more in keeping with malignancy to be triaged effectively8 since f-Hb is directly related to the severity of colorectal disease, with more significant bowel diseases (SBDs) being associated with higher f-Hb 9. Indeed, it has been suggested that the f-Hb could be used to prioritise further investigation, those with higher f-Hb being further investigated sooner 3 4.…”