ABSTRACT
Aim: British Society of Gastroenterology advised reduced level of endoscopic services due to COVID-19 pandemic. This resulted in a significant rise in number of cancer suspected patients waiting for colonoscopy. Quantitative Faecal Immunochemical Test(QFIT)is designed to detect occult blood in stool(0 to 400 ug/g). The value of QFIT is proportional to cancer risk. Therefore, it can be utilised to prioritize cancer suspected referrals prior to colonoscopy. In this audit of service we investigated:1)The reliability of QFIT as prioritization tool for colorectal cancer referrals.2)To investigate the impact of QFIT on colonoscopy burden. Method(s): QFIT was applied to all colorectal cancer suspected referrals to NHS Ayrshire & Arran in September 2020. An interim audit of the outcome was performed focusing on four months' worth of data. QFIT values recorded and subsequent management steps analysed in following categories. QFIT less than 10,10 to 400, and over 400. The highest risk of cancer is within over 400. Result(s): 1258 test kits were dispatched,823(65%)results obtained. QFIT values were as following:631 samples with < 10(77%)of returned samples;of these 490 patients were discharged,27 patients' tests was repeated, and 114 patients were planned for further endoscopic or imaging investigations.143 patients had levels between 10 to 400. The main finding was that 49(6%)patients had QFIT more than 400, and were booked for colonoscopy. Nine patients had a confirmed cancer diagnosis. Conclusion(s): In our cohort,9 patients with QFIT more than 400 were diagnosed with cancer at colonoscopy. This is in concordance with published data reporting similer values. This would re-affirm reliability of QFIT as a prioritisation tool in predicting colorectal cancer. Majority of QFIT less than 10 were discharged following clinic consultation. This resulted in significant reduction of colonoscopy numbers that would have otherwise been performed. Longer term review of all QFIT categories is necessary to advise on its usefulness, out width the pandemic.