Publications by authors named "Jayne Digby"
Aim: Since December 2015, a faecal immunochemical test (FIT) has been provided to primary care in NHS Tayside as an adjunct to clinical acumen in the assessment of new-onset bowel symptoms. The aim of this work was to assess the impact of this approach on time to diagnosis of colorectal cancer (CRC).
Method: NHS Tayside Cancer audit data from January 2013 to December 2019 were reviewed to identify all CRC patients diagnosed via the primary-care referral pathway for a period before and after the introduction of FIT.
Article Synopsis
- The study aimed to improve colorectal cancer (CRC) detection by using risk scoring models (RSMs) alongside faecal immunochemical testing (FIT) in symptomatic patients, potentially reducing the need for endoscopies.
- By analyzing data from nearly 19,000 patients, key factors such as faecal haemoglobin levels, age, sex, and iron deficiency were identified to create a risk score that improved sensitivity for detecting CRC compared to standard f-Hb thresholds.
- The findings suggest that while RSMs may enhance detection in some cases, they did not significantly help patients with very low f-Hb levels, indicating a need for alternative strategies that incorporate additional risk factors beyond just FIT.
Article Synopsis
- A study aimed to create a risk-scoring model for colorectal cancer by analyzing faecal haemoglobin levels and other factors in participants of the Scottish Bowel Screening Programme.
- Data from over 232,000 participants revealed that only faecal haemoglobin concentration and age were significantly linked to colorectal cancer, with a notable interval cancer rate, particularly higher in women (38.1%) than men (27.5%).
- The findings suggest that developing a risk scoring model was not achievable, but adjusting faecal haemoglobin thresholds by age may help address the gender disparity in cancer detection rates.
Article Synopsis
- The study assessed the impact of faecal immunochemical testing (FIT) on colorectal cancer (CRC) diagnosis in NHS Tayside since its introduction in 2015.
- A review of cancer audit data from 2016 to 2019 showed that 75.7% of primary care patients diagnosed with CRC underwent FIT prior to referral, with an increase in FIT usage over the years.
- While FIT triage led to a higher rate of non-emergency presentations for CRC, it did not affect the stage at which the cancer was diagnosed.
Aim: The faecal immunochemical test (FIT) for faecal haemoglobin (f-Hb) helps determine the risk of colorectal cancer (CRC) and has been integrated into symptomatic referral pathways. 'Safety netting' advice includes considering referral for persistent symptoms, but no published data exists on repeated FITs. We aimed to examine the prevalence of serial FITs in primary care and CRC risk in these patients.
View Article and Find Full Text PDFBackground: Polypectomy may be performed at colonoscopy and then subsequent surveillance undertaken. It is thought that faecal haemoglobin concentration (f-Hb), estimated by quantitative faecal immunochemical tests (FIT), might be a useful tumour marker.
Methods: Consecutive patients enrolled in colonoscopy surveillance were approached at two hospitals.
Article Synopsis
- * Results revealed that women had a lower median faecal haemoglobin concentration (720 µg Hb/g) compared to men (473 µg Hb/g), and this difference was most significant for left-sided cancers and earlier stages of the disease.
- * The study suggests that to address these gender disparities, screening programs might consider using different faecal haemoglobin threshold levels for women and men.
Article Synopsis
- Faecal haemoglobin concentration (f-Hb) is a useful tool in primary care for assessing the risk of colorectal cancer (CRC) in patients with lower gastrointestinal symptoms.
- *The study evaluated various f-Hb thresholds to determine when a patient can be reassured versus when they need further investigation, showing that lower thresholds allow for higher percentages of patients to be managed without additional procedures.
- *Overall, the findings suggest that measuring f-Hb, along with clinical evaluations, helps to make informed decisions about CRC risk and patient management in a primary care setting.
Background: There is currently no existing evidence on the effects of personalised risk information on uptake of colonoscopy following first line screening for colorectal cancer. This study aimed to measure the impact of providing risk information based on faecal haemoglobin concentration to allow a fully informed choice around whether or not to undergo colonoscopy.
Methods: Two thousand seven hundred sixty-seven participants from the Scottish Bowel Screening Programme (SBoSP) database, who had not recently been invited for screening, were randomised to receive one of three types of hypothetical risk information materials: (1) numerical risk information (risk categories of one in 40, one in 1600 and one in 3500), (2) categorical risk information (highest, moderate and lowest risk), or (3) positive screening result letter (control group).
Article Synopsis
- Lower gastrointestinal symptoms are not very effective in predicting colorectal cancer (CRC), so this study evaluated how well faecal haemoglobin (f-Hb) levels predict CRC during colonoscopy for symptomatic patients.
- The study involved 4,841 patients in three Scottish NHS Boards, finding that only 0.6% of those with low f-Hb (<10 µg/g) were diagnosed with CRC, compared to 9.4% of those with f-Hb ≥10 µg/g and 22.4% with f-Hb ≥400 µg/g.
- The results suggest that patients with f-Hb ≥10 µg/g should be further investigated for CRC, while those with f-Hb <10 µ
Article Synopsis
- * Among 1,447 patients, it was found that 20.5% were diagnosed with significant bowel disease (SBD) through colonoscopy; notably, most cases of SBD were in patients with higher fecal hemoglobin levels (≥10 g Hb/g feces).
- * The results suggest that patients with rectal bleeding and low fecal hemoglobin levels (<10 g Hb/g feces) are less likely to have serious bowel disease and could potentially be evaluated with a simpler sigmoidoscopy
Article Synopsis
- Faecal immunochemical tests for haemoglobin (FIT) are essential for colorectal cancer screening, guiding follow-up investigations based on faecal haemoglobin concentration (f-Hb) thresholds.
- A study analyzed f-Hb distributions among 887,248 screening participants in Scotland, revealing variations based on sex, age, deprivation levels, and geographical region.
- Findings indicated that f-Hb is consistently higher in men, increases with age and deprivation, and suggests the need for tailored investigation thresholds, contrasting with previous evaluations from other countries.
Article Synopsis
- The study evaluated the accuracy of faecal immunochemical tests (FIT) in detecting colorectal cancer (CRC) in high-risk patients undergoing surveillance colonoscopy.
- Out of 1103 patients invited, 639 completed the test, and some were found to have advanced neoplasia, revealing a significant correlation between detectable faecal haemoglobin (f-Hb) and the presence of neoplasia.
- The findings suggest that measuring f-Hb can effectively indicate risk levels for advanced neoplasia, potentially allowing for more personalized scheduling of colonoscopies in high-risk individuals.
Article Synopsis
- Many primary care patients have lower bowel symptoms, but serious bowel diseases like colorectal cancer and inflammatory bowel disease are rare; fecal immunochemical tests (FIT) help identify those who should get further colonoscopic evaluation.
- This study looked at data from a Scottish NHS Board to see if the FAST score, which includes fecal hemoglobin, age, and sex, improves decision-making for colonoscopy referrals based on FIT results from nearly 5,700 specimens collected in the first year.
- Results showed that while a significant number of patients with serious bowel disease had high fecal hemoglobin levels, using the FAST score could reduce referrals but risked missing some cases, highlighting a balance needed between sensitivity and practicality in screening.
Article Synopsis
- A study aimed to see if a faecal immunochemical test (FIT) for faecal haemoglobin (f-Hb) can be safely used in primary care to rule out serious bowel diseases like colorectal cancer (CRC) and inflammatory bowel disease (IBD).
- The research involved 5422 patients who submitted FIT samples, revealing a positivity rate of 21.9%, with 20.5% of those completing a colonoscopy having significant bowel disease.
- The findings suggest that f-Hb testing, alongside clinical evaluation, is an effective way to assess patients' risk for serious bowel diseases in a primary care setting.
Background: In Scotland a new, easier to complete bowel screening test, the Faecal Immunochemical Test (FIT), has been introduced. This test gives more accurate information about an individual's risk of having colorectal cancer (CRC), based on their age and gender, and could lead to fewer missed cancers compared to the current screening test. However, there is no evidence of the effect on colonoscopy uptake of providing individuals with personalised risk information following a positive FIT test.
View Article and Find Full Text PDFArticle Synopsis
- NICE published guidelines in 2015 (NG12) for suspected colorectal cancer (CRC), which stirred debate over its recommendation for faecal occult blood tests.
- A study compared the effectiveness of faecal immunochemical tests (f-Hb) against NG12 guidelines using data from 1,514 patients, measuring sensitivity and predictive values for significant colorectal diseases.
- Results showed f-Hb had a much higher sensitivity (93.3% for CRC) and negative predictive value (99.7%) compared to NG12, indicating f-Hb is a more reliable initial test for identifying colorectal diseases.
Article Synopsis
- Researchers created the FAST Score, a prediction model for colorectal cancer (CRC) that uses simple factors like fecal haemoglobin concentration, age, and sex to enhance diagnosis in symptomatic patients.
- The model was validated through extensive studies involving over 5,500 patients, showing strong diagnostic accuracy with an AUC of 0.88 in the initial group and 0.91 in the validation group.
- The FAST Score effectively categorizes patients into high, intermediate, and low-risk groups for CRC, making it a practical tool for clinicians in assessing symptoms and prioritizing colonoscopy referrals.
Objective To examine associations between faecal haemoglobin concentrations below the cut-off used in colorectal cancer screening and outcomes in the next screening round. Methods In the Scottish Bowel Screening Programme, faecal haemoglobin concentrations and diagnostic outcomes were investigated for participants with a negative result (faecal haemoglobin concentrations < 80.0 µg Hb/g faeces), followed by a positive result within two years.
View Article and Find Full Text PDFObjectives: Quantitative faecal immunochemical tests (FIT) for faecal haemoglobin (f-Hb) in colorectal cancer (CRC) screening pose challenges when colonoscopy is limited. For low positivity rates, high f-Hb concentration cut-offs are required, but little is known about interval cancer (IC) proportions using FIT. We assessed IC proportions using an 80 µg Hb/g cut-off.
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- The study aimed to evaluate the effectiveness of two tests, faecal haemoglobin (FHb) and faecal calprotectin (FC), in identifying significant bowel diseases such as cancer and inflammatory bowel disease (IBD) among patients with bowel symptoms.
- A sample of 1,043 patients underwent testing, with results showing that 57.6% had detectable FHb and 60% had elevated FC levels; ultimately, 103 patients were diagnosed with significant bowel disease.
- The findings suggest that an undetectable FHb result can reliably rule out significant bowel disease, helping to determine which patients need further investigation.
Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes.
Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.