{
  "abstract": "Introduction The UK has adopted faecal immunochemical testing (FIT) to triage symptomatic colonoscopy referrals. Our Objective is to Quantify diagnostic yield and independent effects of FIT, age, sex, and symptoms on polyp and cancer detection in symptomatic colonoscopy.Methods Nationwide analysis of prospectively collected colonoscopy reports (June 2023–August 2025) through the National Endoscopy Database. Symptomatic procedures, including iron-deficiency anaemia (IDA), were identified and diagnostic yields calculated. Mixed-effects logistic regression estimated adjusted odds ratios (aORs) with age, sex, symptom group and FIT as fixed effects. Post-estimation margins modelled cancer yield by age, FIT, and symptoms.Results Analysis of 447,109 symptomatic colonoscopies identified cancer yield of 1.9% (95% CI 1.8–1.9). FIT≥10μg Hb/g cancer yield was 3.8% (95% CI 3.7–3.9) overall; 2.5% (95% CI 2.3-2.7) in patients aged 40-49 and 0.6% (95% CI 0.5-0.7) in those aged 16-39. Cancer yield in FIT<10 was 0.3% (95% CI 0.2–0.3).FIT concentration was strongly associated with cancer; aOR 46.1 (95% CI 37.2–57.1) at ≥300 vs FIT<10. IDA was associated with cancer versus rectal bleeding (aOR 2.2, 95% CI 2.0–2.3; p<0.01).Modelled estimates showed that with FIT <10, cancer yield exceeded 1% only in IDA patients aged >80, remaining <0.5% otherwise. A model combining FIT, age, and IDA detected >94% of cancers while reducing colonoscopy demand by >40%Conclusions This national analysis demonstrates the superiority of FIT-based triage over symptom-based referral, with FIT≥10 identifying high-risk patients, including those aged 40-49, while FIT<10 signified very low risk across all ages and indications.Abstract O6 Figure 1Visual abstract",
  "authors": [
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, New Castle, United Kingdom"
      ],
      "name": "David Beaton"
    },
    {
      "affiliations": [
        "NorthTees And Hartlepool NHS Foundation Trust, Stockton-on-tees, United Kingdom"
      ],
      "name": "Mahmoud Mohamed"
    },
    {
      "affiliations": [
        "Torbay and South Devon NHS Foundation Trust, Torbay, United Kingdom"
      ],
      "name": "Keith Pohl"
    },
    {
      "affiliations": [
        "New Castle University Center for Cancer and population health, New Castle, United Kingdom"
      ],
      "name": "Linda Sharp"
    },
    {
      "affiliations": [
        "NorthTees And Hartlepool NHS Foundation Trust, Stockton-on-tees, United Kingdom"
      ],
      "name": "Mathew Rutter"
    }
  ],
  "title": "O6 Real-world performance of FIT triage for symptomatic colonoscopy: analysis of the UK national endoscopy database (NED)",
  "uid": "2a40b3b6-f3f4-590a-9b16-0e2c2396a3ba"
}