FIT Test (Faecal Immunochemical Test) for Colorectal CA Screening: How To
Who should get FIT tested: Any patient who is 45 years or older. Reassess at 75 years if this is the right choice for the patient. USPSTF. Someone who has failed multiple bowel preps and is unable to get a colonoscopy for some reason. If your patient has prior colonoscopy showing any abnormalities check with the head TS before choosing FIT.
First Steps: Get a FIT test from clinic (you can go during the week) and register it to your patient. This may take ~30 mins, register the test on our internal tracker. This tracker will show you which email you should input when registering the test so we get the results at the clinic.
Background Info: FIT requires only one stool sample and does not require restrictions to medications or diet prior to providing the sample. Patients should be advised to return/mail the KIT within 24 hours of collection., because FIT sensitivity declines with delayed return after sampling. In one study, delayed return of the FIT more than five days after sampling, compared with no delay, was associated with a decreased rate of adenoma detection (odds ratio [OR] 0.6). It does not require a bowel preparation, sedation, or time away from work or family (although if the FIT is positive, a colonoscopy will be advised for further evaluation). FIT requires only one sample rather than three days of samples as for guaiac-based fecal occult blood testing (gFOBT).FIT can be positive due to an upper gastrointestinal bleed that is large enough for hemoglobin to escape degradation during transit. Frequency- FIT must be done annually to be protective. Council your patients thoroughly that they will do this yearly.
Location: FIT tests are found in David Skovran's office ask the Head TS
Gift Cards: We have gift cards to give patients once they have returned or confirmed they've mailed out their FIT test. You can fill out the log in clinic or use this link to document the GIFT CARD has been distributed.
Remember to update the Problem List Healthcare Maintenance Section that you distributed a FIT Test, with the results, and when next due for FIT or colo.
Additional Information on the Efficacy of FIT Testing: Most countries screen for colorectal cancer using fecal immunochemical testing (FIT) as the initial method. Canada includes flexible sigmoidoscopy as an option, and the United States most commonly uses colonoscopy. The first POEM on gastrointestinal conditions is a Norwegian RCT that invited previously unscreened adults 50 to 74 years of age to undergo flexible sigmoidoscopy (52% had the procedure) or FIT every two years (68% had at least one test).16 Although flexible sigmoidoscopy initially identified more cancers and advanced adenomas, FIT surpassed it over time, with a cancer detection rate of 0.49% after three rounds of FIT testing vs. 0.27% with flexible sigmoidoscopy.Top 20 Research Studies of 2021 for Primary Care Physicians, published 1/1/2022, AAFP