O53 Faecal immunochemical testing: cost effective way stratifying symptomatic patients for urgent straight to test investigation

Abstract

Abstract Introduction Quantitative faecal immunochemical test (FIT) offers the opportunity to stratify symptomatic ‘high risk’ colorectal patients for further investigation. Method FIT was introduced in primary care to stratify ‘high risk’ symptomatic patients aged 60 years and above with a change in bowel habit to determine whether an urgent straight to test (STT) CT colonography (CTC) was indicated. All FIT tests were analysed in a national bowel screening hub using the OC-Sensor platform. A result of ≥ 4 μgHb/gFaeces, was used as the cut-off. All FIT results were cross referenced with a prospectively maintained colorectal cancer registry to determine the colorectal cancer detection rate (CRC). Data was analysed from February 2018-December 2019. Result The mean number of total CTC performed per month pre-FIT was 240 (range 185–278) and reduced to 217 (range 183–264) post-implementation (P < 0.05). The number referred under the STT pathway was 167 (range 119–209) reducing to 131 (range 91–153) (P < 0.05), however there was a corresponding rise in the number of non-STT referrals from outpatients 73 (range 44–105) to 85 (range 60–111) (P < 0.05). Conclusion FIT has the potential to reduce the burden on secondary care investigations to exclude bowel cancer. Our experience has shown that a conservative FIT level of < 4ug/ml has reduced numbers of STT referrals by 22%. Take-home Message FIT can be used for symptomatic patients with a change in bowel habits to stratify the need for further investigations. Post-implementation, FIT has reduced STT referral rates and reduced the burden placed on secondary care.