Faecal Immunochemical Test (FIT)

What are the different ways FIT is used?

The Faecal Immunochemical Test (FIT) is used to detect invisible traces of blood in faeces. It’s used in: 

  • primary care to guide the management of people who present with signs and symptoms of suspected bowel cancer
  • secondary care to support patient triage
  • bowel cancer screening programmes to support the earlier detection and prevention of bowel cancer 

The threshold for a positive result is much lower when FIT is used to manage symptomatic patients than the threshold used in the bowel cancer screening programmes.

Read about the different FIT screening vs symptomatic pathways

How and when to use FIT to manage people with symptoms

FIT results should inform your decision-making when people present with symptoms of bowel cancer. But it can get complicated when patient presentations don’t exactly match guidelines or you suspect cancer in someone with a negative FIT. 

We’ve used the latest research to support your clinical judgement so you can effectively manage and safety net people with colorectal symptoms. 

Managing people using FIT in primary care

FIT symptomatic resources

The biggest barriers people face when a FIT is requested are being frightened of what the test may find and embarrassment about the process of doing the test [1]. 

We surveyed the public to find out what would support them to complete a FIT kit and the most common response was having a step-by-step guide on how to do the test [1]. Download our clear one-page patient guide you can hand out when you request a symptomatic FIT. 

How to complete a symptomatic FIT kit 

You can also download a version of the guide in Welsh.

Other actions healthcare professionals can take to support people complete their FIT are: 

  • Clearly explaining the importance of doing a FIT to patients and sharing accessible information your patients can take home (eg translated guides). 
  • Clearly explaining how to do the test in person or sharing an online video of how to do the test if remote. 
  • If applicable in your area, pre-labelling FIT kits can reduce mislabelling issues which can lead to samples being rejected.  
  • Use safety netting tools to alert you or your practice if somebody has not returned their FIT in a certain timeframe. 

Where people don’t return a FIT kit after you’ve tried the above actions, use national and local guidance to assess the risk of colorectal cancer and determine if referral is appropriate.