Comparison of the QuikRead go (R) point-of-care faecal immunochemical test for haemoglobin with the FOB Gold Wide (R) laboratory analyser to diagnose colorectal cancer in symptomatic patients

Objectives: Faecal immunochemical testing for haemoglobin (FIT) is used to triage patients for colonic investigations. Point-of-care (POC) FIT devices on the market have limited data for their diagnostic accuracy for colorectal cancer (CRC). Here, a POC FIT device is compared with a laboratory-based FIT system using patient collected samples from the urgent referral pathway for suspected CRC. Methods: A prospective, observational cohort study. Patients collected two samples from the same stool. These were measured by POC QuikRead go (R) (Aidian Oy, Espoo, Finland) and laboratory-based FOB Gold Wide (R) (Sentinel Diagnostics, Italy). Faecal haemoglobin <10 mu g haemoglobin/g of faeces was considered as negative. At this threshold, comparisons between the two systems were made by calculating percentage agreement and Cohen's kappa coefficient. Proportion of negative results were compared with Chi squared testing. Sensitivities for CRC were calculated. Results: A total of 629 included patients provided paired samples for FIT to compare the QuikRead go (R) and FOB Gold Wide (R). The agreement around the negative threshold was 83.0% and Cohen's kappa coefficient was 0.54. The QuikRead go (R) reported 440/629 (70.0% of samples) as negative compared to 523/629 (83.1%) for the FOB Gold Wide (R), this difference was significant (p-value<0.001). Sensitivities for CRC detection by the QuikRead go (R) and FOB Gold Wide (R) were 92.9% (95% confidence interval (CI): 68.5-98.7%) and 100% (CI: 78.5-100%) respectively. Conclusions: Both systems were accurate in their ability to detect CRC. Whilst good agreement around the negative threshold was identified, more patients would be triaged to further colonic investigation if using the QuikRead go (R).