Implementing Faecal Immunochemical Testing in Primary Care

The incidence of colorectal cancer (CRC) has increased globally, in particular patients under the age of fifty. This is a pilot study of a faecal immunochemical testing(FIT) service in primary care. The aim was to trial a FIT service for asymptomatic patients.

We offered FIT kits to asymptomatic patients, aged between 40-75 years old during routine consultations. The number of FITs performed and the outcomes were reviewed. A cut-off of >10μg Hb/g faeces was defined as a positive result.

Overall 180 FIT kits were distributed, 7 duplicate tests were given. Of the 173 patients recruited, 142 (82%) samples were analysed in the lab. A total of 126 ( 88.7%) samples had a normal result, 8(5%) were rejected, 31 (17.9%) did not send their sample for analysis. A positive result was found in 8(5%), of these 6 (75%) underwent colonoscopy. No cancer was identified, 4 (50%) had polyps removed and 2 patients require follow up colonoscopy.

This study represents the first successful implementation of a FIT service in primary care in Ireland. There is a significant unmet need in this setting and strong scientific rationale for the use of FIT testing in general practice.