Chemical Pathology

Notes

The Quantitative Faecal Immunochemical Test (qFIT) is used to detect occult blood in faeces. qFIT is available as part of a pilot scheme to replace the Guaiac Faecal Occult Blood test (gFOBt), which has not been available in Gloucestershire primary care for several years. The qFIT has many advantages over the gFOBt, for example, qFIT is specific to human haemoglobin so is less influenced by diet and medication than gFOBt.

In accordance with NICE DG30 (Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care, 2017), the following adult patients with a low probability of having colorectal cancer are eligible to be tested using qFIT:

  • Aged 50 or over with unexplained:
    • abdominal pain OR weight loss
  • Aged 50 - 60 with:
    • Change in bowel habit OR iron deficiency anaemia
  • Aged 60 or over and have anaemia without iron deficiency

The results of the test may be used to help guide referral to secondary care.

In addition to the above, from Monday 23rd November 2020, the use of FIT testing was extended to support GP’s decision making with patients who have suspected bowel cancer and to avoid unnecessary colonoscopies.  Please see the G-Care pathway for more information on when qFIT tests should be requested.

Sample Requirements

FIT packs are delivered to each GP practice in Gloucestershire. The pack contains the sample collection device, patient instructions, and return envelopes.

Suggested GP actions:

  1. GP creates ICE request and prints the form to go with the FIT pack.
  2. Advise patients to follow the collection instructions carefully, including taking care not to let the faeces sample touch the water in the toilet bowl.
  3. Advise patients to return the sample directly to the GP surgery as soon as possible.
  4. The GP surgery should then send all FIT packs to GRH Chemical Pathology laboratory on the routine laboratory transport. Samples will be receipted in the laboratory and sent to North Bristol for analysis.

We also suggest that GP's make a note on the patient’s record that a test has been issued and ensure a process is in place to follow up the result, in case the patient does not return the sample to the surgery. This should be in addition to giving the patient their usual safety netting advice.

Turnaround times

GP practices will receive an electronic result in the same way as other blood and urine requests. Results are usually available within 3 working days of sample receipt in the laboratory.

If you have not had the results within 10 days of issuing the test then please contact the patient to ensure the test was returned to the GP surgery. The GP surgery will need a mechanism in place to identify patients issued with a pack who do not collect the sample.

Further information

  • For more information about FIT, visit the FIT website
  • For more information about laboratory testing, email: nbn-tr.nbtfit@nhs.net
  • To order more kits:
    • If you are part of a group practice and need kits to place at other surgeries, or you would like to order more kits for your own surgery, please email: nbn-tr.nbtfit@nhs.net (do not contact Chemical Pathology at GRH/CGH as we do not hold any stock).
    • Replacement kits should be with you within 5 days

Page last updated: 11/10/2021

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