FIT Guidance for Primary Care

The Faecal Immunochemical Test (FIT) is a type of faecal occult blood test used to detect invisible traces of blood in faeces. FIT is used to guide the management of patients with lower GI symptoms in two key settings*:

It is used to guide the management of patients who present with signs and symptoms in primary care. The test supports GPs to identify which patients should be referred into secondary care or safety netted. It is important to remember to record the date the test is received, not the date it is sent.
FIT is also used as a triage test in secondary care to guide the management of patients who have been referred routinely or on an urgent referral pathway.

*It is important to check local pathways as they may differ nationally and between the regions. 

The symptomatic thresholds for a positive result are much lower than the thresholds used in national bowel cancer screening programmes. In England the threshold for a positive bowel screening test is 120mcg.

Even if a patient has had a negative bowel screening test in the last few months, but has symptoms or signs of bowel cancer, it is essential that a symptomatic FIT test is considered.

Below you will find a host of resources available to support your implementation of this guidance in clinical practice.

Presented by Dr Joe Mays and Dr Sarah Bailey, June 2026

This webinar focused on the use of the Faecal Immunochemical Test (FIT) in primary care for the early detection and management of bowel cancer. Key topics included when to do a FIT test, referral advice for the Lower GI USC pathway and FIT negative follow-up

Presented by Dr Pawan Randev, EMCA Primary Care Lead

This webinar focused on the use of the Faecal Immunochemical Test (FIT) in primary care for the early detection and management of bowel cancer. Key topics included the background of colorectal cancer (CRC), the role and interpretation of FIT, differences between symptomatic and screening pathways, and practical guidance for clinicians.

CRUK have developed resources which outline how FIT supports clinical decision-making, including referral pathways and safety netting strategies.

NHS England have published two letters to support the adoption of the FIT guidance.

This course summary outlines GatewayC’s educational module on the Faecal Immunochemical Test (FIT), designed to support primary care professionals in the early detection of colorectal cancer.

This guideline, developed by the British Society of Gastroenterology (BSG) and the Association of Coloproctology of Great Britain and Ireland (ACPGBI), provides a comprehensive strategy for the use of faecal immunochemical testing (FIT) in patients presenting with signs or symptoms suggestive of colorectal cancer (CRC).

Safety netting in primary care is a vital strategy to support early cancer diagnosis and manage diagnostic uncertainty.

NICE Diagnostics Guidance DG56 provides evidence-based recommendations on the use of quantitative faecal immunochemical testing (FIT) to support referral decisions for suspected colorectal cancer in primary care.

This free course is designed to support primary care professionals in the early recognition and referral of patients with symptoms indicative of colorectal cancer.

This article from the British Journal of General Practice explores newly published guidelines by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) on the use of faecal immunochemical testing (FIT) for patients presenting with symptoms suggestive of colorectal cancer (CRC).

Primary Care Resources

Key Areas