{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T22:32:05Z","timestamp":1788820325069,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013791","name":"Bowel Cancer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013791","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Faecal immunochemical testing (FIT) is used in the detection of colorectal cancer (CRC). FIT is invariably used at a single faecal haemoglobin (f\u2010Hb) concentration threshold. The aim of this observational study was to explore risk scoring models (RSMs) with f\u2010Hb and other risk factors for CRC in symptomatic patients attending primary care, potentially speeding diagnosis and saving endoscopy resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Records of patients completing FIT were linked with The Scottish Cancer Registry and with other databases with symptoms, full blood count and demographic variables, and randomized into derivation and validation cohorts. Stepwise multivariable logistic regression created RSMs assessed in the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 18\u2009805 unique patients, 9374 and 9431 were in the derivation and validation cohorts, respectively: f\u2010Hb, male sex, increasing age, iron deficiency anaemia and raised systemic immune inflammation index created the final RSM. A risk score threshold of \u22652.363, generating the same number of colonoscopies as a f\u2010Hb threshold of \u226510\u2009\u03bcg Hb\/g gave improved sensitivity for CRC in both cohorts. A RSM which excluded f\u2010Hb was used to investigate the effect of raising the f\u2010Hb threshold from \u226510 to \u226520\u2009\u03bcg Hb\/g in those with a low risk score. This approach would have generated 234 fewer colonoscopies but missed four CRCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The RSM conferred no significant benefit to patients with very low f\u2010Hb and CRC. Alternative strategies combining FIT with other variables may be more appropriate for safety\u2010netting of symptomatic patients. Further work to develop and investigate the value of RSM for significant bowel disease other than CRC may also be beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16925","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T04:55:10Z","timestamp":1709268910000},"page":"675-683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Do risk scores improve use of faecal immunochemical testing for haemoglobin in symptomatic patients in primary care?"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-8734","authenticated-orcid":false,"given":"Jayne","family":"Digby","sequence":"first","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening University of Dundee  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-7994","authenticated-orcid":false,"given":"Callum G.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening University of Dundee  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8656-8363","authenticated-orcid":false,"given":"Gavin","family":"Clark","sequence":"additional","affiliation":[{"name":"Public Health Scotland  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-415X","authenticated-orcid":false,"given":"Craig","family":"Mowat","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ninewells Hospital  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4528-1005","authenticated-orcid":false,"given":"Judith A.","family":"Strachan","sequence":"additional","affiliation":[{"name":"Blood Sciences and Scottish Bowel Screening Laboratory Ninewells Hospital and Medical School  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4248-6785","authenticated-orcid":false,"given":"Robert J. 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