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.

Key Points Covered:

• Background & Data: Bowel cancer is the fourth most common cancer in the UK, with over 44,000 new cases and 16,800 deaths annually. Recent data shows an increase in early-stage diagnoses, but incidence is rising among younger adults.
• What is FIT?
  FIT is a quantitative test for blood in stool, replacing older guaiac-based tests. It is used both in screening programmes and for symptomatic patients in primary care.
• When to Use FIT:
  FIT should be used for most colorectal symptoms except when patients present with a rectal or anal mass or ulceration, which require urgent referral without FIT. For other symptoms, FIT helps guide referral decisions.
• Interpreting FIT Results:
  • FIT >10 µg/g (with or without symptoms): Refer via urgent suspected cancer pathway.
  • FIT <10 µg/g: Conduct blood tests, safety net, and consider repeating FIT.
• Common Misunderstandings:
  FIT should be offered even if a patient previously had a negative result in the screening programme. It is now recommended for cases of rectal bleeding due to its high sensitivity.
• Safety Netting:
  Emphasis was placed on safety netting for patients with negative FIT results, including the use of reminder pathways and symptom diaries. NHSE and Accurx have developed resources to support this.
• Barriers to Completion:
  Certain groups, such as men, younger adults, and those in deprived or urban areas, are less likely to complete FIT tests. Addressing these disparities is crucial for improving outcomes.
• Resources & Tools:
  The webinar highlighted free cancer maps for applying NICE guidance, patient resources, and the opportunity to participate in a national safety netting and FIT pilot.

Watch the full webinar below: