Faecal testing

10.15am – 11.45am BST, 11 June 2024 ‐ 1 hour 30 mins

Parallel session

Chair:  Sally Benton

This session will provide an update on how new testing approaches for diagnosis of colorectal cancer and lower GI diseases are evolving.

10.15 - 10.45 - Qualitative (lateral flow) point of care FIT tests - do they work? - Shane O'Driscoll

There are an increasing number of qualitative lateral flow FIT methods available on the market.  These are marketed for health care professionals and/ or public use.  There is often overlap.  NHS England and cancer charities have raised concerns about the availability of these kits and the validity of the results they generate.  The aim of this talk is to provide an overview of kits available on the market and present results from an evaluation carried out to assess a number of these kits.

10.45 - 11.15 - A laboratory experience of calprotectin (and FIT) in clinical pathways - Neil Syme

Faecal testing has been part of the biochemical investigation of disease for a long time. The advent of more automated assays for analytes such as faecal calprotectin and haemoglobin in the last decade has led to huge improvements in diagnosis and management of lower gastrointestinal disease. Stool samples do not typically take the same route to the laboratory as blood. Collection of stool samples lies in the hands of the patient, followed by a period of storage and transport to the laboratory, where they are stored again and extracted prior to analysis. Modern faecal sample collection devices have significantly streamlined this process, enabling safer and more consistent testing, and improved workflow. This talk aims to give an overview of the implementation and challenges of stool testing in a general chemistry laboratory.

11.15 - 11.45 - Implementing faecal immunochemical testing (FIT) into symptomatic pathways the Nottingham experience - David Humes

We implemented FIT testing in our colorectal cancer pathway in Nottingham in 2016 and have developed our pathway following a successful initial pilot study. Since its introduction, we have strived to improve the ability of FIT and other factors to determine which patients should undergo invasive investigations. This has resulted in the development of the Nottingham 4F protocol of a FIT, digital rectal examination, and a full blood count and ferritin prior to referral. Through this we aim to deliver a tailored pathway to risk stratify patients and prioritise investigation in those at most risk of being diagnosed with colorectal cancer. Since its introduction, FIT has acted as a potential barrier to referral in those with symptoms and we have studied the effect sociodemographic factors have on return rates in the symptomatic population. This talk aims:

  1. To describe the implementation of a stratified FIT pathway and its evaluation.
  2. To describe variations in FIT return and use by sociodemographic factors and region.