Gastroenterology Today Summer 2021

FEATURE
in patient uptake in those Trusts and Health Boards that have moved
from postal to GP surgery return, showing that FIT pathways can be
flexible and adaptable to local requirements.
Conclusion
Without doubt, the COVID-19 pandemic has fundamentally changed
many clinical pathways in the health service. Many hope that some of
these innovative changes will continue into the future. This the widely
held opinion regarding the application of FIT, and the recent expansions,
past the original NG12 1 and DG30 2 guidelines, to use FIT in all patients
of all ages presenting with lower bowel symptoms, has provided a
clinically relevant investigation which now is a vital tool in the diagnosis
and treatment of CRC. With new logistics options, patient-centric
literature, and a sample collection device specifically designed for
patient-based sampling, the expansion of FIT will continue to support
endoscopy service for years to come, by helping avoid unnecessary
procedures, and allowing urgent referral for those most at risk of
significant bowel disease.
FIT-KITS have been developed by Alpha Laboratories, working in
collaboration with a large number of NHS and private healthcare
providers across the UK. If you would like to discuss your requirements
to facilitate an efficient process for rolling out FIT for your patients,
please contact digestivedx@alphalabs.co.uk.
With thanks to Professor Callum G Fraser, Centre for Research into
Cancer Prevention and Screening, University of Dundee.
References
1. NICE. Suspected cancer: recognition and referral. NICE guideline
[NG12]. Last updated: 29 January 2021. https://www.nice.org.uk/
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for colorectal cancer in primary care. Diagnostics guidance [DG30].
Published date: 26 July 2017. https://www.nice.org.uk/guidance/
dg30 (Accessed 19 March 2021).
3. Colorectal Cancer Survival by Stage - NCIN Data Briefing. http://
www.ncin.org.uk/publications/data_briefings/colorectal_cancer_
survival_by_stage (Accessed 19 March 2021).
4. Ho KMA, Banerjee A, Lawler M, Rutter MD, Lovat LB. Predicting
endoscopic activity recovery in England after COVID-19: a national
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19 March 2021).
6. https://www.gov.scot/publications/coronavirus-covid-19-guidancefor-use-of-fit-testing-for-patients-with-colorectal-symptoms
(Accessed 19 March 2021).
7. Digby J, Strachan JA, McCann R, Steele RJ, Fraser CG, Mowat C.
Measurement of faecal haemoglobin with a faecal immunochemical
test can assist in defining which patients attending primary care
with rectal bleeding require urgent referral. Ann Clin Biochem
2020;57:325-7. doi: 10.1177/0004563220935622.
8. D’Souza N, Georgiou Delisle T, Chen M, Benton S, Abulafi M;
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diagnostic accuracy study. Gut 2020 Oct 21:gutjnl-2020-321956.
doi: 10.1136/gutjnl-2020-321956. Epub ahead of print.
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CG, Steele RJ. Faecal haemoglobin concentration thresholds for
reassurance and urgent investigation for colorectal cancer based
on a faecal immunochemical test in symptomatic patients in
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10.1177/0004563220985547. Epub ahead of print.
10. https://www.health.org.uk/news-and-comment/charts-andinfographics/non-covid-19-nhs-care-during-the-pandemic
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GASTROENTEROLOGY TODAY - SUMMER 2021
11. Strachan JA, Mowat C. The use of faecal haemoglobin in
deciding which patients presenting to primary care require
further investigation (and how quickly) – the FIT approach.
eJIFCC 2021;32:52-60. https://www.ifcc.org/media/478839/
ejifcc2021vol32no1pp052-060.pdf (Accessed 19 March 2021).
12. Zahida Z, Carolyn P, Benton SC. Does visually over-loaded
HM-JACKarc collection device impact faecal haemoglobin
results? Ann Clin Biochem 2020 Dec 3:4563220976749. doi:
10.1177/0004563220976749. Epub ahead of print.
13. Benton SC, Symonds E, Djedovic N, Jones S, Deprez L, Kocna P,
Maria Auge J; International Federation of Clinical Chemistry Faecal
Immunochemical Test Working Group (IFCC FIT-WG). Faecal
immunochemical tests for haemoglobin: Analytical challenges
and potential solutions. Clin Chim Acta 2021 Feb 9;517:60-5. doi:
10.1016/j.cca.2021.01.024. Epub ahead of print.
14. Alpha Laboratories Ltd. Bespoke patient packs help support cancer
testing progress in the South West. Leading Edge. Vol. 2020, No. 1.
http://files.alphalabs.co.uk/e-mags/Leading_Edge_2020_Issue_1/
page_5.html (Accessed 23 March 2021).
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