New evidence supports using FIT in patients with rectal bleeding

01 Mar 2021

New findings from the RM Partners NICE FIT study have been published this week in Colorectal Disease, showing that FIT (faecal immunochemical test) is effective at ruling out colorectal cancer in patients with suspicious symptoms, including rectal bleeding.

This continues to further the evidence for FIT and reduces unnecessary investigations for patients by ruling out colorectal cancer effectively.

The NICE FIT clinical trial, the largest international study of FIT in ruling out bowel cancer in patients with high risk symptoms, was led by Croydon University Hospital, with Mr Muti Abulafi, Consultant Colorectal Surgeon at Croydon University Hospital, as Chief Investigator.

Dr Georgina Hicks, Colorectal Surgeon Registrar, conducted the additional analysis of NICE FIT data of over 3000 patients that had rectal bleeding and were subsequently referred for a colonoscopy on the two week wait urgent pathway.

In this analysis, 44% of these patients were found to have a positive FIT, of which 10.4% had an eventual diagnosis of colorectal cancer and 32.9% had serious bowel disease. FIT is 99.9% effective at ruling out colorectal cancer in patients with rectal bleeding.

Dr Hicks said: ‘We are very excited to publish this research which we hope will change practice and enable patients to avoid unnecessary investigations but still ensure cancers are detected early.’

‘FIT can exclude cancer in patients with concerning symptoms, allows any cancers to be detected early, and can help triage which patients need more urgent investigation’

FIT is now offered in primary care to patients with symptoms suspicious of colorectal cancer.  It was previously thought that patients with rectal bleeding would not benefit from a FIT test, which picks up blood in stool samples.

These results indicate that despite the presence of rectal bleeding, FIT can still effectively rule out colorectal cancer, reducing the need for an invasive investigation, and onward referral on the 2 week wait pathway.