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Name and Title

The RECEDE Study – REducing Colonoscopies in patients without significant bowEl DiseasE

Recruitment status


Chief investigator

Professor Ramesh Arasaradnam


University Hospitals Coventry & Warwickshire NHS Trust


NIHR Health Services and Delivery Research


To investigate the diagnostic accuracy of stool faecal immunochemical testing (FIT) when used in combination with urine volatile organic compound (VOC) analysis to determine patients who do or do not have significant bowel disease, without the need for a colonoscopy.

Study Design

Prospective diagnostic accuracy study



Sample Size



Investigating people with bowel symptoms uses a test that detects traces of blood in the stools, the Faecal immunochemical Test (FIT). There are many possible reasons for positive tests. A few people have cancer. But most patients with symptoms don’t have any serious bowel disease, but have benign problems such as piles or irritable bowel syndrome. It is very difficult to diagnose on symptoms alone, those patients who have serious bowel disease and those who do not.

After a positive test, people are invited for colonoscopy – a sort of camera examination of the large bowel. Most people invited for colonoscopy don’t have cancer. Only about 5% of those with positive

FIT tests have cancer. About 25% have other bowel diseases, but most (70%) have nothing seriously wrong at all. So, they have the inconvenience and discomfort of colonoscopy but don’t get any benefit from it.

We want to try adding another test, the Volatile Organic Compound (VOC) test, to see if we can separate those with positive FIT tests who do have something wrong, from those who don’t. The VOC test uses a urine sample. Using both tests might also be better for detecting cancer.

So, we think that using both tests might not only be better for detecting cancer, but also might mean that a lot of people will avoid having to have a colonoscopy.

We will recruit 1,819 patients with bowel symptoms from hospitals in different parts of England. They will provide stool samples for FIT and urine for VOC analysis. They will all have a colonoscopy to get a definite diagnosis. Then we will look at their FIT and VOC test results to see if in future, people with both tests negative don’t need colonoscopies.

Planned Start


Planned Duration

30 months


Tel: 02476 966581