Faecal immunochemical testing (FIT) and bowel cancer

17th October 2022 by Louise Hudman

Faecal immunochemical testing (FIT) and bowel cancer

This is a new guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) on the use of FIT testing. It was published in July.

There is a helpful flowchart as part of the guideline. Most of us will have local referral procedures for colorectal cancer and we need to refer in accordance with these. In some areas you may see these changing as a result of this new guidance.

What is new for GPs in this guideline?

  • Different areas probably use different FIT cut-offs for assessment. We may see this becoming more consistent.
  • FIT in the testing of IDA is now advised and there is good evidence that it is accurate. There were previously concerns that it wasn’t accurate enough.
  • Even in the presence of rectal bleeding, or other high-risk symptoms, FIT is still very good at excluding colorectal cancer. Other tests may still be advised.
  • We should proactively follow up patients who don’t have a FIT result. We should follow up whether it has not been processed, or not been returned.

How should GPs include FIT when assessing patients with suspected colorectal cancer?

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