Practitioner perspectives on symptomatic faecal immunochemical testing in the UK: a qualitative interview study.

Area of Science:

• Gastroenterology
• Oncology
• Primary Care Medicine

Background:

• Faecal immunochemical testing (FIT) is integral to managing patients with suspected colorectal cancer symptoms in primary care.
• Positive FIT results (≥10 µg Hb/g) trigger urgent referrals, while negative results lead to routine management.

Purpose of the Study:

• To explore healthcare professionals' experiences with symptomatic FIT delivery.
• To identify perceived benefits, drawbacks, and implementation challenges of FIT pathways.
• To inform future improvements in FIT service delivery.

Main Methods:

• A qualitative study involving semi-structured interviews with UK primary and secondary care professionals.
• Thirty interviews were conducted, guided by an iterative topic guide.
• Thematic analysis was applied to coded interview transcripts.

Main Results:

• Symptomatic FIT enhances clinical decision-making confidence and identifies more patients for colorectal neoplasia investigation.
• Workload impact varied, with primary care often experiencing increased burden.
• Concerns include FIT overuse, investigation burden from false positives, diagnostic delays, and uncertainty regarding rectal bleeding management and repeat FIT value.

Conclusions:

• Symptomatic FIT is generally perceived as beneficial by health professionals.
• Further evidence and guidance are needed for optimal FIT application and management strategies.