980 The Impact of Anticoagulant, Antiplatelet, and Nonsteroidal Anti-Inflammatory Drug (Nsaid) Use on Faecal Immunochemical Testing Measurements in Fast Track Referral Patients
D Suhail, A Elbeltagi, M Lim- Surgery
Abstract
Aim
Faecal immunochemical testing (FIT) has been used as a prioritisation tool and diagnostic adjunct for detection of colorectal cancer (CRC) patients on the fast-track pathway. Many patients referred through the pathway are on medications associated with gastrointestinal bleeding. We chose to study the impact of such medications on FIT measurements.
Method
A retrospective review of patients between March 2020 and August 2022 was conducted. Data on patient demographics, medication use, FIT results and colonoscopy findings were gathered. Patients who did not undergo further investigations and patients diagnosed with CRC were excluded. Patients with a FIT measurement greater than 7μg of haemoglobin/gram of faeces were deemed positive. Chi squared test was used to compare the proportion of patients with a positive FIT in those who were and were not on the above medications. A p-value of <0.05 was deemed significant.
Results
There were 1668 (778 male) patients. Median age was 71 (IQR 62-78) years. CRC was detected in 92 patients. In the 1576 patients without cancer, 164 (10.4%) were on anticoagulants, 242 (15.4%) were on antiplatelets and 82 (5.2%) were on NSAIDs. A significantly greater proportion of patients had a positive FIT when on anticoagulants compared with those who were not (40% vs. 23%, p-value = 0.00). Use of antiplatelets or NSAIDs had no impact on FIT measurements (29% vs 24%, p-value = 0.32 and 18% vs 25%, p-value = 0.36).
Conclusions
Anticoagulants can impact FIT measurements, hence thresholds for a positive result may need to be altered for these patients. We seek to study this further.