D'Souza N, Delisle TG, Chen M, et al. - Researchers conducted a multicenter, double-blinded diagnostic accuracy study in 50 National Health Service (NHS) hospitals across England between October 2017 and December 2019 to investigate the utility of a fecal immunochemical test (FIT) in selecting patients with suspected colorectal cancer (CRC) symptoms for urgent investigation. The final analysis was performed including 9,822 patients. They observed a CRC prevalence of 3.3% at colonoscopy. Decrease in FIT positivity was noted from 37.2% to 19.0% and 7.6% at cut-offs of 2, 10 and 150 µg hemoglobin/g feces (µg/g), respectively. At these cut-offs, the positive predictive values of FIT for CRC were 8.7%, 16.1% and 31.1%, respectively, and the negative predictive values were 99.8%, 99.6% and 98.9%, respectively. Overall findings revealed FIT sensitivity is maximized to 97.0% at the lowest cut-off (2 µg/g). At this cut-off, a negative FIT result can effectively rule out CRC and a positive FIT result is better than symptoms to identify patients for urgent investigations.