Introduction of an integrated primary care faecal immunochemical test referral pathway for patients with suspected colorectal cancer symptoms

Aim To determine the efficacy of a new 2‐week wait pathway that uses the faecal immunochemical test (FIT) in primary care to triage patients with high and low risk symptoms suspicious of colorectal cancer (CRC). This service improvement pilot follows 2017 National Institute for Health and Care Excel...

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Bibliographic Details
Published in:Colorectal disease 2022-12, Vol.24 (12), p.1526-1534
Main Authors: Georgiou Delisle, Theo, D'Souza, Nigel, Tan, Jessica, Najdawi, Ahmad, Chen, Michelle, Ward, Helen, Abulafi, Muti
Format: Article
Language:English
Subjects:
2 week wait
Cancer
Colonoscopy
Colorectal cancer
Colorectal carcinoma
colorectal neoplasms
Colorectal Neoplasms - diagnosis
diagnostic accuracy
Early Detection of Cancer - methods
faecal immunochemical test
Feces - chemistry
FIT
Hemoglobin
Hemoglobins - analysis
Humans
Occult Blood
Primary care
Primary Health Care
Sensitivity and Specificity
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Summary:Aim To determine the efficacy of a new 2‐week wait pathway that uses the faecal immunochemical test (FIT) in primary care to triage patients with high and low risk symptoms suspicious of colorectal cancer (CRC). This service improvement pilot follows 2017 National Institute for Health and Care Excellence guidance, that recommended using FIT to guide referral of patients with low risk, but not high risk symptoms, which continue to be referrred on the 2‐week pathway. Method Patients with high‐ and low‐risk CRC symptoms were tested with FIT and those with faecal haemoglobin (f‐Hb) ≥9.5 μg haemoglobin/g faeces (hereafter μg/g) were referred to secondary care. Results were tracked and primary care prompted to refer if timely referral was not made. Results Between December 2019 and October 2020, 5672 patients presented to primary care with high and/or low risk symptoms warranting investigations. Of these, 622 (11%) patients were referred without a FIT, of whom 36 (5.8%) had CRC. The remaining 5050 patients had a FIT, of which 4187 (83%) were processed to produce a quantitative result. Of these, 1085 patients (25.9%) had an f‐Hb ≥9.5 μg/g and of those, 982 patients (90.5%) were referred and 56 (5.7%) had CRC. A total of 3102 patients (74.1%) had an f‐Hb
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.16294