QFIT as a tool to prioritise symptomatic suspect colorectal cancer referrals

Aim: The COVID-19 pandemic is an evolving healthcare challenge causing secondary disruption of cancer services. Quantitative Faecal Immunochemical Testing (qFIT) has been established as a screening method in asymptomatic patients. We aim to assess its utility as a triage tool to prioritise investigations in symptomatic patients with suspected colorectal cancer. Methods: At the commencement of the COVID-19 pandemic a database was established to include patients awaiting red flag outpatient consultation or colonic investigations and new red flag referrals from March to June 2020. Patients were supplied with qFIT kits and returned results categorised into 3 priority groups according to the qFIT value. Group 1 >150μg Hb/g, Group 2 ≥10 to ≤150μg Hb/g and Group 3 150 μg Hb/g a sensitivity and specificity for colorectal cancer of 94.12% (95% CI 71.31% to 99.85%) and 91.21% (95% CI 87.20% to 94.29%) respectively. No malignancy was detected in Priority Group 3;negative predictive value of 100% (95% CI 98.06% to 100%). Conclusion: In symptomatic, suspect lower GI cancer patients qFIT is useful in prioritising patients and can be used to determine the urgency of colorectal investigations.