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Cancer research

Limited Utility of Faecal Immunochemical Testing in Cystic Fibrosis Patients

Strategic Insights

— 2 min read

Researchers at the University of Manchester have conducted a study to evaluate the effectiveness of faecal immunochemical testing (FIT) in detecting colorectal cancer (CRC) in patients with cystic fibrosis (CF). The study found that FIT showed poor sensitivity and modest specificity in detecting polyps, and its utility as a screening adjunct in CF patients remains unclear. The researchers recommend that colonoscopy should remain the preferred modality for CRC screening in CF patients, given its high adenoma prevalence and limitations of FIT.

Key Takeaways:

  • The study evaluated the diagnostic performance and uptake of FIT in a CRC screening programme in a UK CF centre, involving 113 eligible patients aged 40 years.
  • Of 66 patients who returned FIT, 49 had FIT and colonoscopy, and 27 underwent colonoscopy only, with colonic polyps detected in 27.6% (21/76) of patients.
  • FIT demonstrated poor sensitivity (14%) and modest specificity (86%) at the 10 g Hb/g threshold, and quantitative FIT values did not correlate with polyp presence (area under the receiver operating characteristic curve 0.48).
  • Bowel preparation was adequate (mean Boston Bowel Preparation Scale 6.8), with a low repeat colonoscopy rate (14.5%).
  • The researchers concluded that FIT did not aid colonic polyp detection and found no correlation between faecal haemoglobin and adenoma detection.
  • Colonoscopy should remain the preferred modality for CRC screening in CF patients due to its high adenoma prevalence and limitations of FIT.
  • The study was conducted by Dipesh H Vasant, Aqeem Azam, Andrew M Jones, Peter J Barry, Javaid Iqbal, Rowland J Bright-Thomas, Karuna Sapru, Anne-Marie Kelly, Graham Horsman at the University of Manchester, Manchester, England.
  • The study was published in BMJ Open Gastroenterology, a peer-reviewed journal.

Statistics:

  • 113 eligible patients with cystic fibrosis participated in the study.
  • 66 (58.4%) patients returned FIT.
  • 49 (43.4%) patients had both FIT and colonoscopy.
  • 27 (23.9%) patients underwent colonoscopy only.
  • 21 (27.6%) patients had colonic polyps.
  • FIT sensitivity was 14% at the 10 g Hb/g threshold.
  • FIT specificity was 86% at the 10 g Hb/g threshold.
  • Bowel preparation was adequate (mean Boston Bowel Preparation Scale 6.8).
  • Repeat colonoscopy rate was 14.5%.

Sources:

  • Vasant, D. H., et al. "Limited utility of faecal immunochemical testing in a colorectal cancer screening programme for adults with cystic fibrosis: insights from a prospective UK study." BMJ Open Gastroenterology, vol. 12, no. 1, 2025.
  • Respiratory Therapeutics Week. "Research from University of Manchester Has Provided New Data on Cystic Fibrosis." September 22, 2025.

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