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Requesting Faecal Immunochemical Testing

Faecal Immunochemical Testing (FIT) is a more sensitive measure of whether there is blood in a patients stool than tradition FOB testing. We are being asked to carry out FIT on patients before referring for 2WW lower GI, as colonoscopy and CT colonography are aerosol generating procedures.

Patients who should be referred without FIT are:

  • Aged 50 and over with unexplained rectal bleeding only
  • Adults aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings:
    • Abdominal pain
    • Change in bowel habit
    • Weight loss
    • Iron deficiency anaemia
  • Adults with a rectal mass or abdominal mass likely to be colonic in origin

Refer patients on 2WW following FIT if

  • Aged 40 and over with unexplained weight loss and abdominal pain ONLY if FIT >10.
  • Aged 50 and over with unexplained:
    • Abdominal pain or weight loss only ONLY if FIT >10.
  • Aged under 60 with:
    • Change in bowel habits or Iron-deficiency anaemia ONLY if FIT >10
  • Aged 60 or over with:
    • Iron deficiency anaemia ONLY if FIT >10
    • Change in bowel habits ONLY if FIT >10.

Consider an alternative diagnosis ie. Coeliac disease, upper GI disease, or non-bowel pathology, if FIT not suggestive of lower GI malignancy or bleeding.

Attached is a guide on how to request FIT via Labeltrace/DART OCM