{"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":1788820325066,"version":"build-2803163510"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Data derived for this study were in part funded by Detect Cancer Early initiative (Scottish Government) and Chief Scientist Office."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Faecal haemoglobin concentration (f-Hb), estimated using a faecal immunochemical test, can be safely implemented in primary care to assess risk of colorectal cancer (CRC). Clinical outcomes of patients presenting with symptoms of lower gastrointestinal disease were examined using an extensive range of f-Hb thresholds to decide on reassurance or referral for further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients who attended primary care and submitted a single faecal specimen faecal immunochemical test in the first year of the routine service had f-Hb estimated using HM-JACKarc: f-Hb thresholds from &lt;2 to\u2009\u2265\u2009400\u2009\u00b5g Hb\/g faeces (\u00b5g\/g) were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Low f-Hb thresholds of &lt;2, &lt;7, &lt;10 and &lt;20\u2009\u00b5g\/g gave respective CRC risks of 0.1, 0.3, 0.3 and 0.4%, numbers needed to scope for one CRC of 871, 335, 300 and 249, and \u2018false negative\u2019 rates of 2.9, 11.4, 13.3 and 17.1%. With thresholds of &lt;2, &lt;7, &lt;10 and &lt;20\u2009\u00b5g\/g, 48.6, 74.6, 78.1 and 83.2% respectively of symptomatic patients could be managed without further investigation. With reassurance thresholds of &lt;2\u2009\u00b5g\/g, &lt;7\u2009\u00b5g\/g and &lt;10\u2009\u00b5g\/g, the thresholds for referral for urgent investigation would be &gt;400\u2009\u00b5g\/g, \u2265200\u2009\u00b5g\/g and \u2265100\u2009\u00b5g\/g. However, patients with a f-Hb concentration of &lt;10 or &lt;20\u2009\u00b5g\/g with iron deficiency anaemia, or with severe or persistent symptoms, should not be denied further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In primary care, f-Hb, in conjunction with clinical assessment, can safely and objectively determine individual risk of CRC and decide on simple reassurance or urgent, or routine referral.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004563220985547","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:19:56Z","timestamp":1608250796000},"page":"211-219","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Faecal haemoglobin concentration thresholds for reassurance and urgent investigation for colorectal cancer based on a faecal immunochemical test in symptomatic patients in primary care"],"prefix":"10.1177","volume":"58","author":[{"given":"Craig","family":"Mowat","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, University of Dundee, School of Medicine Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-8734","authenticated-orcid":false,"given":"Jayne","family":"Digby","sequence":"additional","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening, University of Dundee, School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A","family":"Strachan","sequence":"additional","affiliation":[{"name":"Department of Blood Sciences, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca K","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Blood Sciences, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis A","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland, 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, School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert JC","family":"Steele","sequence":"additional","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening, University of Dundee, School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"bibr1-0004563220985547","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v7.i12.422"},{"key":"bibr2-0004563220985547","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12220"},{"key":"bibr3-0004563220985547","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X709433"},{"key":"bibr4-0004563220985547","unstructured":"Scottish referral guidelines for suspected cancer, http:\/\/www.cancerreferral.scot.nhs.uk\/lower-gastrointestinal-cancer\/ (accessed 1 October 2020)."},{"key":"bibr5-0004563220985547","unstructured":"National Institute for Health and Care Excellence. 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