Start Date May 2018
In 2017 NICE guidance DG30 suggested using faecal immunochemical tests (FITs) in primary care for patients whose symptoms suggest possible colorectal cancer, but do not represent a great enough risk of cancer for an urgent referral. This guideline was mainly drawn from evidence of FIT accuracy among patients at higher risk referred to secondary care and from screening studies, and may not be completely applicable to patients at lower risk, tested in primary care.
Working with the East of England Cancer Alliance, this study aims to assess the acceptability of FIT use among symptomatic primary care patients and their GPs. The FIT-East study is complementary to the FIT-southwest study (PIs Hamilton & Bailey), which is studying routinely collected data to determine the accuracy of the FIT test in this primary care setting.
This mixed-methods study is recruiting patients from general practices in Norfolk and Suffolk as they are offered a FIT test. We are collecting data from (1) each consenting patient; (2) primary care records for clinical outcomes; (3) hospital labs for results of FIT and other tests; (4) and via interviews with patients and their GPs.
We are including patients aged 40 years and over who are seen by their GP with possible symptoms of colorectal cancer, who do not meet the urgent referral criteria (NICE guideline NG12), and for whom the GP orders a FIT.
Outputs & impact
We expect to publish at least one article reporting findings from this study. Together with the FIT Southwest study, we expect to influence the evidence base for the use of FIT, with more guidance on FIT use in different patient groups, and to impact future guidelines on FIT in symptomatic primary care patients.
We will next build on the outcome of this study to further improve early detection of colorectal cancer.