Our comment on new Faecal Immunochemical Test (FIT) pilot study
Today (Wednesday 12 April) the University College London Hospitals (UCLH) NHS Foundation Trust Cancer Collaborative launches the largest pilot study of its kind in the UK to see if a simple test that people can do in their own homes can effectively ‘rule-out’ the presence of bowel cancer amongst patients with abdominal symptoms.
The pilot is led by Bowel Cancer UK medical advisor, Michael Machesney, Pathway Director for Colorectal Cancer, London Cancer. If successful, the research team believe that the test could reduce the number of patients experiencing unnecessary colonoscopies by 40% and transform the way that bowel cancer is diagnosed.
The Faecal Immunochemical Test, known as FIT, detects hidden quantities of blood in a stool sample that could indicate bowel cancer. FIT is a quantitative test which means it can be adjusted to make it more or less accurate at detecting blood in the stool. It is much more sensitive than other similar stool tests currently being used.
There is growing evidence that FIT could accurately ‘rule-out’ bowel cancer for patients with suspicious lower abdominal symptoms with over 95% accuracy. The test is being adopted into the bowel cancer screening programmes in Wales, Scotland and England but this research is testing its use in primary care in people with potential bowel cancer symptoms.
The National Institute for Health and Care Excellence (NICE) are due to publish guidance on the use of FIT in primary care in June 2017.
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, says:
“This is an important pilot study that adds to an increasing evidence base for the use of FIT in primary care to help triage people with symptoms for further diagnostic tests quickly and effectively. Evidence from a similar pilot study in Scotland has also suggested that using FIT in this way could help reduce the number of people referred unnecessarily for colonoscopies and therefore avoid an invasive test. This could help reduce the increasing demand on endoscopy units by directing scarce resource to those who would most benefit. It is hoped that the study will also find that FIT used in this way will rule out the possibility of cancer quickly.
“The study is important because endoscopy units, who deliver diagnostic tests such as colonoscopies, are struggling to deal with the amount of people being referred. This is impacting on the length of time people are waiting for these crucial diagnostic tests - a trend that is set to continue. In fact, reports estimate that nearly a million more endoscopies in England alone will be needed year on year to meet the increasing demand of an ageing population and an increase in symptom awareness. Not only do we need to find ways, such as those being tested in the pilot study, to reduce referrals for an endoscopy, we also need to increase our endoscopy capacity across the board.
“At Bowel Cancer UK we are calling for:
- A national endoscopy strategy in each nation of the UK that addresses how units can best meet increasing demand.
- A national endoscopy training programme to ensure that we can meet the demand for the highly trained staff needed to safely provide a high quality endoscopy service.
- National clinical leadership to drive forward urgently needed improvements in endoscopy.”
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