Faecal immunochemical test (FIT) for bowel cancer detection

On 7 June 2016, Public Health Minister Jane Ellison announced that the Faecal Immunochemical Test (FIT) would replace the NHS Bowel Cancer Screening Programme’s home testing kit (the Guaiac Faecal Occult Blood Test (gFOBT)).

The announcement followed a recommendation from the UK National Screening Council (UK NSC) to do so, after a large-scale pilot study in 2014 showed that FIT was a simpler and more sensitive test and would be likely to increase screening uptake. In 2015/16, gFOBT annual uptake was less than 60%.

When the change was announced, Public Health England aimed to introduce the FIT in an immediate nationwide switch in spring/summer 2018, with the test being offered every 2 years to all men and women registered with a GP between the ages of 60–74.

Delayed implementation

Challenges with procurement of the FIT test kits resulted in delayed implementation. 

In May 2018, in answer to a question about the roll out of FIT, the Parliamentary Under-Secretary of State for Health and Social Care, Steve Brine, acknowledged delays and said, 'I am as frustrated as anyone that it has taken so long [to implement]'. Baroness Benjamin asked about the expected implementation date in a debate in the House of Lords in July 2018. The government stated they expected the FIT to be rolled out in England in autumn/winter 2018.

Ultimately, implementation began in June 2019.

Eligible screening age

The FIT replaced the gFOBt in November 2017 in Scotland, where the NHS offers screening every 2 years for people aged 50–74. In April 2018, a petition signed by over 445,000 people calling for the FIT’s eligible screening age in England to be lowered to the same as Scotland was handed to Secretary of State for Health and Social Care Jeremy Hunt.

In August 2018, the NSC recommended that FIT testing should be offered those aged 50–74 and the threshold for an abnormal result lowered. Ministers agreed with the NSC’s recommendations and stated that NHS England and Public Health England would consider how to implement the lower age for screening in the NHS Long Term Plan. 

Source(s)

Public Health England.
UK National Screening Committee recommendations: annual report.
UK government; 2015.

Department of Health.
New bowel cancer screening test [webpage].
UK government; 2016.

House of Commons.
Bowel Cancer Screening. 01 May 2018, Volume 640.
Hansard; 2018.

House of Lords.
Health: Endoscopy and Bowel Cancer.
Hansard; 2018.

UK National Screening Committee.
The UK NSC recommendation on Bowel Cancer screening in adults.
PHE; 2018.

Public Health England, Brine S.
Bowel screening to start at 50 [webpage].
UK government; 2016.

Richards M.
Review of national cancer screening programmes in England.
NHS England; 2019.