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A FIT approach: improving sample integrity for faecal haemoglobin testing

Faecal immunochemical testing is the latest advance in the screening programme designed to identify patient with colorectal cancer, but success relies on the quality of the sample, as Matthew Davies explains.

The National Institute for Health and Care Excellence (NICE) NG12 guidelines on cancer recognition and referral were issued in 2015. Now, NICE has reintroduced faecal occult blood tests (FOBTs) back into the diagnostic pathway for those low-risk patients with suspected lower gastrointestinal cancers. This has put a strain on pathology departments to provide a test for the presence of blood in faeces.

This presents a challenge, given that in response to the former 2005 guidelines, many pathology departments discontinued their FOBTs, which were, at that time, the traditional guaiac-based tests (gFOBTs). For some, the decision that now has to be made to satisfy NG12 is which test to implement. Technology has moved on to embrace more analytically and clinically sensitive methods such as the quantitative faecal immunochemical test (FIT) for haemoglobin on systems such as the HM-JACKarc.

The second major challenge has been the logistics of getting a quality sample from the patient to the laboratory for analysis. In part, this depends on the technology to be employed for the detection of faecal haemoglobin (f-Hb). In the days of guaiac-based faecal testing, samples were sent in traditional blue-capped ‘stool pots’. This was clearly wrong, as haemoglobin in native faeces is very unstable.1

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Upcoming Events

Pathology Horizons 2024

MacDonald Bath Spa Hotel, Bath
18-20 April, 2024

Diagnostics North East Conference 2024

The Catalyst, Newcastle upon Tyne
19 April, 2024

ECCMID 2024 - European Congress of Clinical Microbiology and Infectious Diseases

Fira Gran Via, 08038 Barcelona, Spain
27-30 April 2024

British Society for Microbial Technology Annual Microbiology Conference

UK Health Security Agency, Colindale, London
2 May 2024

EQA Reports: Interpreting Key Information & Troubleshooting Tips

ONLINE - Zoom
Thursday 16th May 2024

Participants’ Meeting: UK NEQAS Immunology, Immunochemistry & Allergy

Sheffield Hallam University, City Campus, Howard Street, Sheffield
24th May 2024

Access the latest issue of Pathology In Practice on your mobile device together with an archive of back issues.

Download the FREE Pathology In Practice app from your device's App store

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