TTP1.11 An outcome of reassessment of 2740 colorectal (CRC) cancer referrals with initial qFIT<7ugHb/g, a retrospective audit

Colorectal cancer is one of the most common cancers in the UK. qFIT (faecal immunochemical test) was proposed as an adjunct test to prioritize urgent cancer suspected referrals (UCS). qFIT has a high negative predictive value (NPV) for significant bowel disease. A threshold of FIT <10μg Hb/g is selected for discharge to primary care without clinical assessment in most Trusts. The purpose: To determine the outcome of re-assessment of symptomatic patients with initial qFIT <7ugHb/g. Method: A survey of a prospective collected dataset on colorectal UCS referrals over 3 years was completed, (Jan2021-Dec 2023). The outcome of investigations for qFit<7ugHb/g subgroup was analysed. The focus here was on cohort of qFit<7ugHb/g who were not initially assessed and recalled after a mean period of 6 months. All patients offered a consultant phone assessment. Results: After Initial clinical phone assessment 29% underwent colonoscopy. Only 0.14% of this cohort was found to have invasive cancer (n=4).. 71% were not investigated and reassured. After a mean period of 6 months, a cohort of 225 of patients with no initial clinical assessment were re- invited. 24 patients failed to respond. 47% had a second qFIT <7ugHb/g and discharged. 49% discharged without any further investigation. 5 patients underwent colonoscopy which were normal. No cancer found on this reassessment. Conclusion: This study reaffirms reliability of qFIT <7 in excluding significant pathology even after reassessment within 6 months.