Evidence map›Paper›PMID 37668669›Full record

ArticleBJS open2023

Risk-stratified faecal immunochemical testing (FIT) for urgent colonoscopy in Lynch syndrome during the COVID-19 pandemic.

Anne G Lincoln, Sally C Benton, Carolyn Piggott, Shama Riaz Sheikh, Andrew D Beggs, Leah Buckley, Bianca DeSouza, James E East, Pete Sanders, Michael Lim and 15 more

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in BJS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

25 authors at 15 institutions in 1 country.

Anne G LincolnCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Sally C BentonDepartment of Clinical Biochemistry and NHS Bowel Cancer Screening South of England Hub, Royal Surrey County Hospital, Berkshire and Surrey Pathology Services, Guildford, Surrey, UK.
Carolyn PiggottDepartment of Clinical Biochemistry and NHS Bowel Cancer Screening South of England Hub, Royal Surrey County Hospital, Berkshire and Surrey Pathology Services, Guildford, Surrey, UK.
Shama Riaz SheikhCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
Andrew D BeggsDepartment of Surgery, Queen Elizabeth Hospital, Birmingham, UK.ORCID 0000-0003-0784-2967
Leah BuckleyClinical Genetics, St Michael's Hospital, Bristol, UK.
Bianca DeSouzaClinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
James E EastTranslational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
Pete SandersTranslational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
Michael LimTranslational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
Donal SheehanTranslational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
Katie SnapeSouth West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK.
Helen HansonSouth West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-3303-8713
John R GreenawayDepartment of Gastroenterology, James Cook University Hospital, Middlesbrough, UK.
John BurnTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
David NylanderGastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Menna HawkinsFamily Cancer Clinic, St Mark's Hospital, London, UK.
Fiona LallooManchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Kate GreenManchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Thomas J LeeGastroenterology Research, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
Julie WalkerGastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK.
Gillian MatthewsGastroenterology, County Durham and Darlington NHS Foundation Trust, Darlington, UK.
Terry RutherfordGastroenterology, County Durham and Darlington NHS Foundation Trust, Darlington, UK.
Peter SasieniCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.ORCID 0000-0003-1509-8744
Kevin J MonahanFamily Cancer Clinic, St Mark's Hospital, London, UK.ORCID 0000-0002-7918-4003
John Radcliffe Hospital · GBKing's College London · GBCounty Durham and Darlington NHS Foundation Trust · GBRoyal Surrey County Hospital · GBSt George’s University Hospitals NHS Foundation Trust · GBSt Mark's Hospital · GBUniversity of Manchester · GBGuy's and St Thomas' NHS Foundation Trust · GBJames Cook University Hospital · GBNewcastle University · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBNorthumbria Healthcare NHS Foundation Trust · GBQueen Elizabeth Hospital Birmingham · GBSouth Tyneside and Sunderland NHS Foundation Trust · GBSt Michael's Hospital · GB

Funding

Cancer Research UK C8162/A16892Department of Health
6 · The paper itself

Abstract

backgroundLynch syndrome is a hereditary cancer disease resulting in an increased risk of colorectal cancer. Herein, findings are reported from an emergency clinical service implemented during the COVID-19 pandemic utilizing faecal immunochemical testing ('FIT') in Lynch syndrome patients to prioritize colonoscopy while endoscopy services were limited.

methodsAn emergency service protocol was designed to improve colonoscopic surveillance access throughout the COVID-19 pandemic in England for people with Lynch syndrome when services were extremely restricted (1 March 2020 to 31 March 2021) and promoted by the English National Health Service. Requests for faecal immunochemical testing from participating centres were sent to the National Health Service Bowel Cancer Screening South of England Hub and a faecal immunochemical testing kit, faecal immunochemical testing instructions, paper-based survey, and pre-paid return envelope were sent to patients. Reports with faecal haemoglobin results were returned electronically for clinical action. Risk stratification for colonoscopy was as follows: faecal haemoglobin less than 10 µg of haemoglobin/g of faeces (µg/g)-scheduled within 6-12 weeks; and faecal haemoglobin greater than or equal to 10 µg/g-triaged via an urgent suspected cancer clinical pathway. Primary outcomes of interest included the identification of highest-risk Lynch syndrome patients and determining the impact of faecal immunochemical testing in risk-stratified colonoscopic surveillance.

resultsFifteen centres participated from June 2020 to March 2021. Uptake was 68.8 per cent amongst 558 patients invited. For 339 eligible participants analysed, 279 (82.3 per cent) had faecal haemoglobin less than 10 µg/g and 60 (17.7 per cent) had faecal haemoglobin greater than or equal to 10 µg/g. In the latter group, the diagnostic accuracy of faecal immunochemical testing was 65.9 per cent and escalation to colonoscopy was facilitated (median 49 versus 122 days, χ2 = 0.0003, P < 0.001).

conclusionFaecal immunochemical testing demonstrated clinical value for Lynch syndrome patients requiring colorectal cancer surveillance during the pandemic in this descriptive report of an emergency COVID-19 response service. Further longitudinal investigation on faecal immunochemical testing efficacy in Lynch syndrome is warranted and will be examined under the 'FIT for Lynch' study (ISRCTN15740250).

Indexed as

Colorectal Neoplasms, Hereditary NonpolyposisCOVID-19ColonoscopyHumansPandemicsState Medicine

Identifiers

PMID37668669
PMCPMC10478750
OpenAlexW4386439123

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.