Testing for people with bowel symptoms
For patients who have visited their GP because of bowel symptoms, the faecal immunochemical test (FIT) is an easy, cheap and non-invasive test that detects hidden blood in a stool sample that may suggest bowel cancer. If the GP suspects cancer, the patient should be offered a FIT kit to do at home and return to the practice.
The score associated with this test can give a GP a good idea of the patient’s risk of having bowel cancer and can be used to help the GP to decide on the best hospital pathway referral for the patient.
This video explains to patients how to do the FIT test at home.
Using FIT for symptomatic patients in North Central London
The North Central London Cancer Alliance led one of the largest FIT research studies in England. Completed in 2020, it focused on using FIT with high-risk symptomatic patients. The study demonstrated that using FIT is nearly four times more effective in identifying bowel cancer than symptoms alone. It also showed that by using FIT up to 80% of patients could avoid more invasive investigations to exclude bowel cancer.
As a result of this study, a new pathway has been introduced in North Central London for patients with a low FIT score. They are no longer referred on a suspected cancer pathway, but instead managed on a routine pathway for their care. This pathway has support from NHS England and is an innovative way of managing patients who statistically have a very low risk of having bowel cancer. This is called the FIT<10 pathway.
A service evaluation is being run alongside the new pathway and the findings of this will shape how patients with low FIT scores are managed and will be shared nationally.
GPs can refer appropriate patients onto this pathway. Hospitals can also move patients to this pathway if they had been referred on a suspected cancer pathway but their risk of actually having cancer is low. Patients are cared for under the appropriate service and low risk patients avoid having unnecessary invasive investigations.
This video explains to GPs when and how to use the FIT<10 pathway.