ISG Summer Meeting 2024

Poster Presentations
First Prize

Ms Clare Foley
Mater Misercordiae University Hospital, Dublin

FIT Testing and Colon Capsule; A new first line of endoscopy triaging?

TBA (24S142)

FIT Testing and Colon Capsule; A new first line of endoscopy triaging?

Author(s)

Foley C, Vaughan E, Bennett G, Leyden J.

Department(s)/Institutions

Mater Misercordiae University Hospital, Dublin 7.

Introduction

Endoscopy waiting times are increasingly lengthy in post pandemic gastroenterology

Aims/Background

Faecal immunochemical testing (FIT) is a proven screening test for advanced colonic neoplasia, providing a means to expedite colonoscopy in FIT positive or reassure FIT negative patients. The implementation of colon capsule video endoscopy has also been shown to be a safe and effective method to assess for colonic pathology.

Method

This study assessed the outcome of index FIT test for symptomatic patients. A retrospective analysis of a large cohort of colonoscopies was carried out to assess suitability for colon capsule as an alternative to conventional colonoscopy in selected patients.

Results

233 FIT Tests were dispatched to symptomatic referrals. 157 were returned (67%). FIT negative was a result <50ng/ml. 84% were FIT negative (132/157); 37% discharged to GP, 42% referred for OPD review, 19% for routine colonoscopy (19%) and 2% left sided colonoscopy (2%). Of the 16% FIT positive (24/157), 3 colorectal cancers, 8 cases of advanced polyps and 2 cases of IBD were detected. None of the patients referred for full colonoscopy had any contraindication to a CC. To determine if CC would be a viable alternative to colonoscopy in selected patients, 202 ‘routine’ colonoscopies were reviewed. 14 patients had significant colonic pathology (7%). No patients had any contraindications to CC. 24% had a predictor of poor CC outcome, chronic constipation the most common.

Conclusions

This study reinforces the value of FIT testing to identify significant bowel pathology. This study also highlights a potential role for CC as an alternative to low yield colonoscopy. A move to using both FIT and CC would significantly reduce colonoscopy waiting list times and reserve colonoscopy for intervention and FIT positive patients.

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