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New guidance on Faecal Immunochemical Testing (FIT) published

Wednesday 1 June 2022

New guidance on the use of Faecal Immunochemical Testing, known as FIT, in patients with signs or symptoms of suspected bowel cancer has been published by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG).

FIT detects hidden quantities of blood in a stool sample that could indicate bowel cancer. This guidance offers advice on the use of FIT with patients who have signs and symptoms of suspected bowel cancer who may need further investigation. It aims to provide a clear strategy for the use of FIT in the diagnostic pathway.

Key recommendations for use with patients:

  • FIT should be used by primary care clinicians to prioritise patients with suspected bowel cancer for referral for urgent investigation
  • FIT should be used at a sensitivity level of 10 ug/g (micrograms of blood per gram of faeces) in primary care to select patients with lower gastrointestinal symptoms for an urgent referral pathway for further investigation
  • Patients should not be excluded from referral from primary care for symptoms on the basis of FIT testing alone

The full summary of guidance can be found here.

Bowel Cancer UK are one of 61 stakeholders, including members of the public, charities, primary and secondary care clinicians, who inputted into the development of this guidance.

A summary of the guidance has been published to encourage primary care clinicians, including GPs, to begin using FIT in primary care for patients as soon as possible. The full guidance will be published shortly and will be presented at the annual BSG conference on Tuesday 21 June 2022, as well as published in Gut, the leading international journal in gastroenterology.

Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, welcomes this guidance: "It was a privilege to have the opportunity to input into the development of this important guidance on the use of FIT for patients presenting with bowel cancer symptoms. Those with low risk symptoms, especially younger people, often face a delayed diagnosis or have to see their GP a number of times before being referred for further tests. This guidance will help GPs to better identify and refer the right patients for further testing quickly and could help detect bowel cancer at an earlier stage when it is more treatable and curable.

"GPs will need to be supported to put the guidance into practice. We look forward to working with the clinical community to ensure this is done consistently throughout the country."

The Faecal Immunochemical Test (FIT) in England (left) and Scotland (right). Images courtesy of Public Health England and NHS Health Scotland.

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