Chandrapalan, Subashini (2021) The performance of faecal immunochemical test and urinary volatile compounds in the detection of colorectal adenomas and their role in polyp surveillance : (FAST study). PhD thesis, University of Warwick.

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Abstract

Colorectal polyp surveillance plays a major role in the prevention of colorectal cancer. Non-invasive surveillance modalities, therefore, attract considerable attention.

In this study, the performance of FIT varied depending on the cut-off levels chosen. Overall, its sensitivity was higher at lower thresholds, whilst a steady decline was noted at higher cut-off levels. Higher specificity was observed at higher cut-off levels. FIT had shown a better performance in the detection of a high-risk finding. At the threshold of 10 ug/g faeces, the sensitivity and specificity of FIT for the detection of a high-risk finding were 0.54 (95% confidence interval (CI), 0.43 to 0.65) and 0.79 (95% CI, 0.73 to 0.84) respectively. Moreover, in our study, age, sex, proton pump inhibitor therapy, anticoagulation therapy, antiplatelet therapy and non-steroidal anti-inflammatory drugs did not have any effect on the performance of FIT.

The analysis of VOC demonstrated that a high-risk finding could be differentiated with the area under curve of 0.74 (sensitivity of 0.92 (95% CI, 0.86 to 0.97) and specificity of 0.62 (95% CI, 0.55 to 0.68). The combined performance of FIT and VOC, in a serial testing manner, was superior to either of those tests conducted alone.

The combination of FIT and VOC can be utilised in polyp surveillance, as a triage tool in risk-stratifying patients.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Library of Congress Subject Headings (LCSH):	Colon (Anatomy) -- Examination, Colon (Anatomy) -- Cancer -- Diagnosis, Intestinal polyps -- Diagnosis, Volatile organic compounds -- Health aspects, Medical screening
Official Date:	September 2021
Dates:	Date Event September 2021 UNSPECIFIED
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Arasaradnam, Ramesh P.
Format of File:	pdf
Extent:	151 leaves : illustrations, charts
Language:	eng

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