Sociodemographic variation in symptomatic faecal immunochemical testing return: a population-based analysis of 125 659 patients.

Abstract

In the UK, patients presenting in primary care with possible symptoms of colorectal cancer complete faecal immunochemical testing (FIT) as triage for (urgent) colorectal investigation. Little is known about FIT completion rates or sociodemographic variations in these. To measure overall FIT return for the year 2023 and assess sociodemographic variation in completion. A population-based analysis of FIT requests made in 2023 to one pathology laboratory serving the North East, North Yorkshire, and Shropshire. The study included patients aged ≥18 years, for whom sex, postcode sector, and return status were recorded. Index of Multiple Deprivation quintiles, ethnicity tertiles, and rural-urban categories were assigned. Multiple logistic regression assessed associations between sociodemographic characteristics and test (non-)return within 10 weeks. Sensitivity analyses were undertaken: a) excluding younger patients (aged <50 years); and b) removing the 10-week window for test return. In total, 93% (<i>n</i> = 116 786/125 659) of patients returned their test. Of those who returned them, 54% (<i>n</i> = 63 534) did so within 1 week; only 5% (<i>n</i> = 5637) took >3 weeks. Patients aged <50 years, male patients, those in the most deprived and ethnically diverse areas, and urban residents all had a significantly higher likelihood of non-return. Findings were unchanged in sensitivity analyses. Although FIT completion was high, sociodemographic patterning of (non-)return was evident. Further work is needed on barriers to and facilitators of FIT completion to inform measures to address these observed inequalities and support patients to access timely diagnosis.