Faecal Immunochemical Testing (FIT) Guidance Update local guideline or pathway

In 2017 we introduced faecal immunochemical testing (FIT) to deliver the recommendations of NICE (DG12) to help in the management of patients in primary care with low risk symptoms of colorectal cancer. Our recent evaluation of this data (1) shows that this approach has good diagnostic accuracy and in November 2020 NHS England recommended its use for triaging patients with lower GI symptoms (2).

 

In Oxfordshire, the current specimen requirements are a standard stool pot. We chose this when we introduced the test because we were not sure that patients could reproducibly use the collection device supplied by the manufacturer. However, the advantage of these devices is that they contain buffer to stabilise haemoglobin and there is now adequate evidence the collection devices can be used effectively by patients.  We are therefore switching to using this method of collection. This will bring us into line with other centres across the UK and the National screening programme. 

 

Envelopes entitled "Faecal Immunochemcal Test (FIT) Pack" have now been sent to your practice. Each envelope contains a collection device, a green transparent bag, a written "how to complete your test" instructions for patients, and a return envelope. The barcode already on the outside of the collection device will not be used. You will also need a usual orange biochemistry request card.

 

Reccommended sample request process:

  • GP requests FIT on ICE
  • GP applies a small ICE label onto the collection device and the  small green bag.
  • GP applies the large ICE label onto the outside of the orange biochemistry request card.
  • Patient collects sample at home with collection device by following the "how to complete your test" instructions
  • Patient seals collection device into the small green bag, then into the orange biochemistry bag, and finally in the return envelope.
  • Patient returns the full package to the GP surgery to return to OUH.

In addition, we attach a youtube link (3) to share with patients to ensure correct usage. Please do contact us if you have any question using our advice email (clinicalbiochemistry.advice.ouh@nhs.net).

 

  1. Nicholson BD et al Aliment Pharmacol Ther. 2020;52:1031-1041
  2. https://www.nice.org.uk/Media/Default/About/COVID-19/Specialty-guides/triaging-patients-with-lower-gi-symptoms.pdf
  3. https://www.youtube.com/watch?v=gFCk1ejDQD4
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