Fecal immunochemical test (FIT) currently not available for colon cancer screening
All lab providers in BC have suspended fecal occult blood testing using the fecal immunochemical test (FIT) due to a manufacturer reagent problem. The reagent is a liquid solution that is used in the testing of FIT samples. The labs are working to resolve this as quickly as possible and will have a better idea of timing in the next few weeks; however, early estimates indicate that it could take a number of months for FIT testing to resume.
- Presently, no laboratories in BC are offering FIT.
- Do not refer average risk patients for fecal immunochemical testing using the Standard Outpatient Laboratory Requisition at this time.
- If you’ve referred patients for other tests, they can bring the requisition to the lab to have those other tests complete. Your patient will not be given a FIT kit at this time.
- The Colon Screening Program will communicate with you when FIT is available again.
- Yes, you can continue to refer higher than average risk patients (strong family history of colon cancer or personal history of adenomas) for colonoscopy using the Colon Screening Program colonoscopy referral form.
- A strong family history of colon cancer is defined as:
- a. One first degree relative (mother, father, sister, brother, daughter or son) with colon cancer diagnosed under the age of 60; or,
- b. Two or more first degree relatives with colon cancer diagnosed at any age; or,
- For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).
- Patients who have had an abnormal test result should continue to be assessed for colonoscopy by Health Authority staff. Please continue to communicate that this result is common (more than 15 per cent require further testing) and that it does not mean that cancer was found.
- Patients who have received a normal result do not require further follow-up at this time.
- The Colon Screening Program will mail them a reminder notification when it’s time to re-screen.
- Asymptomatic, average risk patients should await reintroduction of FIT rather than reverting to a guaiac-based FOBT as the latter has much lower sensitivity and requires careful dietary preparation to avoid false positives.
- For patients with lower gastrointestinal symptoms or iron deficiency anemia, neither FIT nor guaiac-based FOBT are indicated and these individuals should be referred for consideration of colonoscopy.
- Screening is only recommended for people who are asymptomatic.
- If your patient is experiencing symptoms, refer them directly to a specialist for assessment.
- The Colon Screening Program will communicate with you when FIT is available again. Visit www.screeningbc.ca/colon for updates regarding the availability of FIT.
- If you have questions about the FIT please contact your lab for further information. If you have questions about the Colon Screening Program, please call 604-707-6359.
The provincial Colon Screening Program promotes early detection and prevention of colorectal cancer. The program is NOT intended for:
- Individuals who are up to date for colon screening.
- Patients who have had a FIT in the preceding 2 years, or colonoscopy or flexible sigmoidoscopy in the preceding 10 years for average risk patients; or a colonoscopy in the preceding 5 years for higher than average risk patients.
- Individuals who have a personal history of colorectal cancer, ulcerative colitis or Crohn’s disease.
- These patients should continue to obtain care through their specialist or health care provider.
- Individuals who currently have symptoms, e.g., rectal bleeding, persistent change in bowel habits, abdominal pain, unintentional weight loss or iron deficiency anemia.
- These patients should be referred to a specialist. No FIT required.
- Individuals who are on a definite surveillance plan through a specialist.