In collaboration with Oxfordshire CCG and Oxford University Hospitals Trust we are evaluating the utility of faecal immunochemical tests (FIT) in primary care patients with lower abdominal symptoms. The goal is to determine how FIT can be optimized to deliver the best outcomes for patients and to reduce burden on the health care system. 

FIT is a non-invasive test that can detect blood in patient stool samples and indicate whether a patient is at higher risk of colorectal cancer. FIT tests are already used in the National Bowel Cancer Screening Programme routinely and are posted to patients, where they take the test at home and return it by mail.

Our research focuses on how the test can be used in patients who present to primary care with abdominal symptoms to distinguish which patients might need a colonoscopy and how to prioritize those at highest risk.

We answer questions that will guide policies around diagnostic pathways for colorectal cancers locally and nationally. For example,

• What is the diagnostic accuracy of FIT in symptomatic people presenting to primary care? How does this vary by age, sex, or presenting symptoms?
• How can FIT be used in primary care to prioritise symptomatic patients for urgent referral to hospital based investigation of colorectal cancer?
• What triage methods are most appropriate in a strained healthcare setting (i.e., during the COVID-19 pandemic)?
• Can results from routine blood tests complement FIT to improve the diagnostic accuracy?
• How is FIT being used in primary care? Does uptake vary according to patient, practice, or regional factors?

Additional Information for GP's and Patients 

The learnings from this research will inform guidelines for implementation of FIT for primary care. For example, one of our latest studies was used to inform the Joint Guidelines from the Association of Coloproctology of Great Britain and Ireland and the British Society of Gastroenterology on FIT in patients with signs or symptoms of suspected colorectal cancer. 

Cancer Research UK

Oxford Centre for Early Cancer Detection

Thames Valley Cancer Alliance

Brian Shine, Consultant Chemical Pathologist, Oxford University Hospitals

Andres Tamm, DPhil Candidate, Big Data Institute

Eva Morris, Professor, Nuffield Department of Population Health

Jim Davies, Professor, Department of Computer Science

James East, Associate Professor and Consultant Gastroenterologist, Oxford University Hospitals & Oxford University

Oxford University Hospitals Trust

Oxfordshire CCG

Big Data Institute

Nuffield Department of Population Health

Oxford Department of Computer Sciences