NICE Guidance
1. Quantitative faecal immunchemical tests to guide referral for colorectal cancer in primary care [DG30] Published: 26 July 2017
This guidance recommends the use of FIT in general practice for patients who have bowel symptoms but do not meet the criterial for the suspected cancer referral pathway.
https://www.nice.org.uk/guidance/dg30/chapter/1-Recommendations
2. NICE - Suspected Cancer: recognition and referral [NG12] Updated 15 December 2021
This guidance highlights the groups at risk of colorectal cancer for appropriate referral to secondary care (hospitals) via the suspected cancer referral pathway.
British Society of Gastroenterology guidance
FIT may be used amongst symptomatic patients to identify those who require prioritisation for colorectal investigation (see BSG guidance)
Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG). (Monahan K & colleagues, Gut 2022)
NHS National Bowel Cancer Screening Programme
For information on the National Bowel Cancer Screening Programme follow the following link. It applies to 60-74 year olds but is currently being rolled out to younger age groups.
https://www.nhs.uk/conditions/bowel-cancer-screening/
Cancer Research UK
For information on bowel cancer screening on the CRUK website please follow the following link https://www.cancerresearchuk.org/about-cancer/bowel-cancer/getting-diagnosed/screening
Publications
Schreuders EH, Grobbee EJ, Spaander M, Kuipers EJ. Advances in Fecal Tests for Colorectal Cancer Screening. Current Treatment Options in Gastroenterology volume 14, pages 152–162 (2016)
Arana-Arri E, Idigoras I, Uranga B et al. EUSKOLON group. Population-based colorectal cancer screening programmes using a faecal immunochemical test: should faecal haemoglobin cut-offs differ by age and sex? BMC Cancer 2017 Aug 29;17(1):577.
Passamonti B , Malaspina M , Fraser CG. A comparative effectiveness trial of two faecal immunochemical tests for haemoglobin (FIT). Assessment of test performance and adherence in a single round of a population-based screening programme for colorectal cancer. Gut 2018 Mar;67(3):485-496.
Clark G, Strachan J, Carey F, et al. Transition to quantitative faecal immunochemical testing from guaiac faecal occult blood testing in a fully rolled-out population-based national bowel screening programme. Gut 2020;0:1–8. doi:10.1136/gutjnl-2019-320297
Murphy J, Halloran S, Gray A. Cost-effectiveness of the faecal immunochemical test at a range of positivity thresholds compared with the guaiac faecal occult blood test in the NHS Bowel Cancer Screening Programme in England. BMJ Open 2017 Oct 27;7(10):e017186.
Moss S, Mathews C, Day TJ, et al. Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test: results from a pilot study within the national screening programme in England. Gut2017 Sep;66(9):1631-1644.
Digby J, Fraser CG, Carey FA, et al. Interval cancers using a quantitative faecal immunochemical test (FIT) for haemoglobin when colonoscopy capacity is limited. J Med Screen. 2016 Sep;23(3):130-4.
Monahan KJ, Davies MM, Abulafi M, et al. Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG). Gut.2022 Jul 12;gutjnl-2022-327985.
D’Souza N, Delisle TG, Chen M, et al. NICE FIT Steering Group. Faecal immunochemical test is superior to symptoms in predicting pathology in patients with suspected colorectal cancer symptoms referred on a 2WW pathway: a diagnostic accuracy study. Gut 2021 Jun;70(6):1130-1138.
D’Souza N, Delisle TG, Chen M, et al. NICE FIT Steering Committee. Faecal immunochemical testing in symptomatic patients to prioritize investigation: diagnostic accuracy from NICE FIT Study. Br J Surg 2021 Jul 23;108(7):804-810.
D’Souza N, Monahan K, Benton SC, et al. NICE FIT Steering Group. Finding the needle in the haystack: the diagnostic accuracy of the faecal immunochemical test for colorectal cancer in younger symptomatic patients. Colorectal Dis 2021 Oct;23(10):2539-2549.
Bailey JA, Weller J, Chapman CJ, et al. Faecal immunochemical testing and blood tests for prioritization of urgent colorectal cancer referrals in symptomatic patients: a 2-year evaluation. BJS Open. 2021 Mar 5;5(2):zraa056.
Johnstone MS, Miller G, Pang G, et al. Alternative diagnoses and demographics associated with a raised quantitative faecal immunochemical test in symptomatic patients. Clin Biochem. 2022 Jul;59(4):277-287.