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All below info taken from cancer research uk website

Bowel cancer screening reduces bowel cancer mortality. Since bowel cancer screening began in the UK, it has made use of a certain type of faecal occult blood test - a guaiac-based test (gFOBT). Now, the guaiac test is being replaced by a Faecal Immunochemical Test (FIT) test.

The bowel screening programme is intended for people without any signs or symptoms suggestive of bowel cancer.

In Scotland, FIT replaced guaiac Faecal Occult Blood testing (gFOBt) as the test for bowel screening in November 2017.

In England, the change is expected to happen in Spring/Summer 2019.

In Wales FIT started to replace gFOBt through a phased roll out, with 1 in 28 people receiving the new kit from the end of January 2019. Northern Ireland are yet to make a formal commitment to introduce FIT to their bowel screening programme.

The launch process will be carefully managed. Patients who are invited to take part in screening in the run up to launch won’t be able to transition to FIT until their screening episode is closed so please encourage them to do whatever test it is that they receive.

Further details for the above countries will be shared once they are available.

FIT may also be used as an investigation in the diagnosis of colorectal cancer in certain symptomatic patients. 

The current national guidance for FIT testing in low risk symptomatic patients is contained in NICE DG30. It recommends the use of FIT in primary care to guide referral for suspected colorectal cancer in patients without rectal bleeding, who have unexplained symptoms, but do not meet the criteria for a suspected cancer referral pathway (amounting to a risk of cancer less than 3%). This should form the basis of local defined policy.

The purpose of the FIT is to help identify patients who may have adverse bowel pathology who require colonoscopy or CT colonography. However, not all patients with colorectal cancer will have an abnormal FIT result and symptoms which indicate use of FIT may also reflect other types of cancer; so persisting symptoms would still require further management investigation. 

For symptomatic patients falling into the defined higher risk groups (warranting 2ww referral in NICE guidelines), FIT is not currently nationally recommended, and so referral under 2ww is appropriate. There are research projects looking at this now, which will provide valuable evidence on this topic. In the meantime, cancer alliances in England have been advised by NHS England to prioritise the full implementation of DG30.

Key things to know

https://www.cancerresearchuk.org/health-professional/screening/bowel-screening-evidence-and-resources/faecal-immunochemical-test-fit#FIT4

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