Faecal Immunochemical Test (<10)

NCL Wide

The faecal immunochemical test (FIT) <10 NG12 follow up pathway was introduced in NCL in April 2021, as part of a service evaluation programme. It is separate to the suspected lower gastro-intestinal cancer pathway (specific for FIT>10).

On the FIT <10 NG12 pathway, patients will be booked by the hospital for repeat bloods (FBC), FIT and a follow up clinic in eight to 10 weeks. They will have a face-to-face clinic appointment with a consultant or senior SpR (or equivalent) to determine the management plan.

Possible outcomes include discharge to GP, consultant upgrade onto urgent cancer pathway, further investigations on referral to treatment (RTT) pathway. This cohort of patients will be tracked based on referral source on a specific tracking list in order to differentiate them from the suspected cancer and RTT patient tracking list. This differentiation means that the safety-netted patients will not distort suspected cancer performance reporting and will be easy to identify. 

Following national guidance and in collaboration with NCL providers, NCL Cancer Alliance has developed pathways within the colorectal services to move patients, who have appropriate symptoms, from the suspected lower gastro-intestinal cancer pathway to the FIT<10 NG12 follow up pathway. If a patient is referred on the suspected lower gastro-intestinal cancer pathway and they have a FIT<10 but do not have a rectal mass, anal mass, anal ulceration or iron deficiency anaemia, following a clinical consultation with the patient (to exclude alarming symptoms), they may be moved to the FIT<10 NG12 follow up pathway (seeDownloads). 


Eligibility Criteria

Inclusions

A FIT<10 and

  • an abdominal mass or
  • a change in bowel habit or
  • aged 40+ with unexplained weight loss and abdominal pain or
  • aged <50 with rectal bleeding and either of the following unexplained symptoms:
    • abdominal pain
    • weight loss or
  • aged 50+ with any of the following unexplained symptoms:
    • rectal bleeding
    • abdominal pain
    • weight loss or
  • aged 60+ with anaemia (not iron deficiency anaemia)

Exclusions

  • iron deficiency anaemia
  • rectal mass
  • anal mass
  • anal ulceration

Patients with a rectal mass, an unexplained anal mass or unexplained anal ulceration should be referred on the LGI suspected cancer pathway.
FIT should be offered even if the person has previously had a negative FIT result through the NHS bowel cancer screening programme.


How to Refer

EMIS form

Referral methods: e-Referrals

Following FIT test results, if there is need to refer, complete the correct referral form.

  • 2WW - Lower GI Suspected Cancer
  • Colorectal FIT less than 10 - NCL

How to find service on e-RS

 

  • Priority: Routine
  • Speciality: GI and Liver
  • Clinic type: Colorectal Surgery
  • Service name: FIT <10 NG12 follow-up - Colorectal Surgery - ‘chosen hospital name’

Where to find the form

  • Barnet: BAR Global Documents > 2WW Cancer Referral Forms
  • Camden: Camden Global Documents > 2WW Cancer Referral Forms
  • Enfield: ENF Global Documents > 2WW Cancer Referral Forms
  • Haringey: HAR Global Documents > 2WW Cancer Referral Forms
  • Islington: ISL Global Documents > 2WW Cancer Referral Form

Downloads



Review date: Tuesday, 18 November 2025