REMEDY : BNSSG referral pathways

Fit Test

Checked: 02-07-2018 by Rob.Adams Next Review: 02-07-2019

Overview

FIT (Faecal immunochemical test) has now implemented across BNSSG in early June and can be requested in patients without rectal bleeding who are classed as at 'low risk but not no risk' of colorectal cancer.

If a patient fulfils the existing Lower GI - 2WW guidelines then do not issue a FIT test and refer immediately as before.

Consider qFIT testing in patients:

  • aged over 50 with unexplained abdominal pain OR weight loss
  • aged 50 to 60 with changes in bowel habit OR iron-deficiency anaemia
  • aged 60 or over with anaemia without iron deficiency

FIT packs will be delivered to each practice in June 2018.

Administering the test

Explain to the patient the reason for the test and the importance of completing it.

Remove the request form from the pack, complete it making sure you tick at least one of the indication boxes, and return it to the pack

Give the pack to the patient and advise them to read the instructions carefully before they send the pack to the lab in the envelope provided.

Record that you have issued the pack using the read code 4791 (Faecal Occult Blood Requested) on your clinical system (SNOWMED ID 167666002).

What the results mean

If qFIT positive: consider referral for suspected colorectal cancer

If qFIT negative: colorectal cancer is extremely unlikely.

What to do next

qFIT has a very high negative predictive value for colorectal cancer in low-risk populations. If your patient still has symptoms of concern on reassessment, you may wish to consider seeking local specialist advice.

Referral

For patients in the appropriate groups with positive FIT test please refer via Lower GI -2WW pathway

For patients who have a negative FIT test but who still require further advice or endoscopy then please consider the following:

Endoscopy.

Advice and Guidance - Gastroenterology.

Anaemia