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Using faecal immunochemical test (FIT) undertaken in a national screening programme for large-scale gut microbiota analysis
  1. Andrea C Masi1,
  2. Sara Koo2,3,
  3. Christopher A Lamb4,5,
  4. Mark A Hull6,
  5. Linda Sharp3,
  6. Andrew Nelson7,
  7. James S Hampton2,3,
  8. Colin J Rees2,3,
  9. Christopher J Stewart1
  1. 1 Gastroenterology, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
  2. 2 Gastroenterology, South Tyneside General Hospital, South Shields, UK
  3. 3 Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
  4. 4 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
  5. 5 Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  6. 6 Leeds Institute of Biomedical & Clinical Sciences, St James’s University Hospital, Leeds, UK
  7. 7 Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
  1. Correspondence to Professor Colin J Rees, Gastroenterology, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; colin.rees{at}

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We read with great interest the article by Gudra et al 1 reporting a faecal immunochemical test (FIT; OC-Sensor, Eiken Chemical) commonly used in colonic neoplasia screening as a reliable sampling device for microbiome profiling when compared with immediately frozen samples from whole stool. The potential to use the FIT routinely completed by approximately 3 million participants annually as part of the English Bowel Cancer Screening Programme2 to understand the role of gut microbiome in colorectal neoplasia holds great promise, not least because of the convenience to individuals, cost-savings associated with use of routinely collected samples, and methodological advantages of samples collected before microbiome-altering procedures (eg, bowel cleansing).3

We aimed to validate and expand on the finding of Gudra et al 1 by investigating performance of the Bowel Cancer Screening Programme (BCSP) FIT, analysing more subjects, testing longer-term storage, investigating different methods of concentration and comparing with OMNIgene.GUT (OG; DNA Genotek), a widely used research device for stool DNA preservation at ambient temperature.4 We considered bacterial profile stability over time, mimicking real-world research scenarios with storage of FIT samples for up to 20 days prior to DNA extraction. We …

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  • ACM and SK are joint first authors.

  • CJR and CJS are joint senior authors.

  • Twitter @DrChrisLamb, @BottProf

  • Contributors AM, AN, CS and CAL recruited volunteers and analysed samples. SK, MH, LS, JH and CJR designed the study. All authors contributes to study design, analysis of results and edited the article. CJR and CS led the work and wrote first and last drafts of the article.

  • Funding This research was funded as part of COLOCOHORT research grant from Guts UK AMRC charity.

  • Competing interests CJR has received grant funding from ARC medical, Norgine, Olympus. He was an expert witness for ARC medical. CJR and LS have received grant funding from 3D Matrix. CAL receives research support from Genentech. CS has performed consultancy for Astarte Medical.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.