{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:08:29Z","timestamp":1789189709875,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to determine the diagnostic accuracy of the faecal immunochemical test (FIT) for colorectal cancer (CRC) in symptomatic patients with different levels of anaemia severity or the presence of iron deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Symptomatic patients (2018\u20132021) from primary care were followed up prospectively for CRC for 2\u2009years. The positive predictive values (PPV) for CRC of FIT subgroups were compared between anaemia severity groups and iron deficiency groups once stratified for symptom type and demographics. The diagnostic accuracy of FIT for CRC was investigated for different definitions of iron deficiency anaemia (IDA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 17\u2009538 symptomatic patients were investigated, including 310 with CRC (1.8%). In FIT\u2009&lt;\u2009100\u2009\u03bcg haemoglobin (Hb)\/g subgroups, the PPV for CRC was unchanged between anaemia severity levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). In groups with FIT\u2009&lt;\u2009100\u2009\u03bcg Hb\/g, the PPV for CRC was unchanged in the presence of IDA, non\u2010iron\u2010deficiency anaemia and iron deficiency without anaemia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). In the anaemia and IDA subgroups investigated, FIT 10\u201319\u2009\u03bcg Hb\/g had a PPV of &lt;3% for CRC and increasing the FIT cut\u2010off to 20\u2009\u03bcg Hb\/g could have hypothetically saved 28.6% of colonoscopies. Including transferrin saturation in the definition of IDA increased the detection of CRC in FIT\u2010negative patients (sensitivity 9.1% vs. 3.9%) but with a low CRC pick\u2010up rate (PPV\u2009=\u20090.6%; 165 colonoscopies per CRC). Investigating FIT\u2010negative functional IDA would increase the detection of CRC by 1.3% but with a PPV of 0.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The diagnostic accuracy of FIT is excellent regardless of the severity of anaemia, iron deficiency, symptom type or demographics. The FIT cut\u2010off can be increased safely to 20\u2009\u03bcg Hb\/g irrespective of anaemia severity or iron deficiency. Altering the definition of IDA does not pragmatically increase the detection of CRC in negative\/low FIT patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70024","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T23:50:18Z","timestamp":1739231418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic accuracy of quantitative faecal immunochemical test in symptomatic patients for the investigation of colorectal cancer once accounting for anaemia severity and iron deficiency"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6979-7818","authenticated-orcid":false,"given":"James","family":"Lucocq","sequence":"first","affiliation":[{"name":"Department of Colorectal Disease Victoria Hospital  Kirkcaldy UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Barron","sequence":"additional","affiliation":[{"name":"Department of Colorectal Disease Victoria Hospital  Kirkcaldy UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Colorectal Disease Victoria Hospital  Kirkcaldy UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Donnelly","sequence":"additional","affiliation":[{"name":"School of Medicine University of St Andrews  St Andrews UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Cruickshank","sequence":"additional","affiliation":[{"name":"Department of Colorectal Disease Victoria Hospital  Kirkcaldy UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.22034\/APJCP.2017.18.2.405"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta21330"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15405"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u2010230X\u201011\u201065"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741\u20107015\u20107\u201017"},{"key":"e_1_2_12_7_1","unstructured":"National Institute for Health and Care Excellence.Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care.2023www.nice.org.uk\/guidance\/dg56"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102021\u2010324856"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i38.6415"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102015\u2010309579"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i19.2383"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.700753"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102017\u2010314472.280"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15776"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2018.0030"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17632"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010020\u201001221\u20109"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102021\u2010325210"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102022\u2010327985"},{"key":"e_1_2_12_20_1","volume-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"WHO","year":"2011"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010321956"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228874"},{"key":"e_1_2_12_23_1","unstructured":"NICE\u2010NG12.Suspected cancer: Recognition and referral. NICE Guideline no. 12.2015."},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004563220985547"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620949714"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.1098"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604165"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo\u201019\u2010451"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.4627"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrab056"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010059940"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad016"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70024","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.70024","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:55:00Z","timestamp":1789188900000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/codi.70024"],"URL":"https:\/\/doi.org\/10.1111\/codi.70024","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70024"}}