Quick test can help rule out bowel cancer sooner for patients

People with potential bowel cancer symptoms are being urged to take a quick test at home which could help rule out the disease much sooner.

Patients experiencing symptoms which could be seen as a sign of bowel cancer will be asked by their GP to complete a stool test, which will arrive at their home by post.

Known as a Faecal Immunochemical Test (FIT test), patients can complete the test in the comfort of their own home before sending it off in the post.

The simple test checks for blood in the poo and helps to screen patients who may be at risk of bowel cancer.

Dr Gemma Eccles (pictured), Swansea Bay’s primary care cancer clinical lead, said: “Under national guidance, patients with a symptom that could be related to bowel cancer should complete a FIT test before being referred to secondary care.

“Of course, there are some symptoms that don’t need a FIT test before a referral can be made, for example, if a mass has been found by a GP.

“The test acts as a way of screening and triaging patients to help determine if they are at low risk, if they need to be seen more urgently or not at all.

“The test is exactly the same as the bowel screening test, which goes out to people aged between 50 and 74, except it is for people with symptoms.

“We as GPs request the test for them and it is sent to their home in the post.”

Despite initially seeking help from their GP practice for their symptoms, a number of people do not end up completing the FIT test.

Gemma stressed the importance of doing the test and how not completing it could lead to a potential delay in diagnosis.

“Some people can be put off by doing a stool test for a number of reasons,” she said.

“These tests have been used nationally for bowel cancer screening for years and there has been a lot of research into why some people don’t do it.

“But we are using them for people who have gone to their GP because they are worried about a symptom, yet some still don’t do the test.

“Not doing the test can delay a potential diagnosis. They need to be completed but if they aren’t, it slows things down and can even result in a missed cancer diagnosis.”

Gemma decided to look into the reasons why people weren’t completing their FIT tests, and teamed up with staff from City Health Local Cluster Collaborative (LCC) to contact patients directly.

Each GP practice within the LCC, which covers the south-east and central areas of Swansea, rang patients to try and discover why they hadn’t done their tests.

Gemma added: “We knew who had had a test requested by their GP practice and who hadn’t had a result.

“Each practice rang their own patients and we gave them a questionnaire which included questions such as if they received the kit, if they knew why they had the kit, did they understand what it was for and how to use it.

“We had 67 responses and some of them said they didn’t understand how to do the test, some said they were too uncomfortable to do it, some had been sent for blood tests by their doctor and those results were fine so they didn’t think they had to do the test.

“Some people had symptoms such as diarrhoea and waited until they felt better to do it, which we wouldn’t advise.

“We want patients to know that if they have received a test that they weren’t expecting or if they aren’t sure how to do it, they can just contact their GP practice and ask them.

“We can tell patients how to do the test or perhaps send them more information but we can’t help if patients don’t let us know.”

Dr David Howell is a GP partner at Kingsway Surgery, within City Health LCC, and was involved in the project.

He said: “If your doctor has requested a FIT test, it’s vitally important to complete it.

“The test looks for hidden blood in your stool, which can help us decide whether further investigations, like a colonoscopy, are needed.

“Delaying or not completing the test could lead to delays in diagnosing serious conditions, such as bowel cancer.

“A positive FIT test does not necessarily mean a serious condition, but it allows us to arrange further investigations if needed.

“On the other hand, a negative FIT result can be very reassuring and may mean no invasive procedures, such as a colonoscopy, are required.”

Once the tests have been sent off and the results come through, patients may be referred for further tests in hospital.

Gemma said: “It depends on each patient individually, but the referral may result in a test straight away, or they might get invited to see a consultant or might get invited for a scan.”

Rhys Jenkins, City Health LCC lead, said: “We were pleased to be a part of Dr Eccles’ FIT test non-responder project.

“We are aware of perceived barriers to access within the cluster when considering our diverse and deprived population.

“We understand that there may be rationale in some cases when patients do not undertake tests that a GP may have advised so we were very interested in speaking to patients to understand these reasons.

“We are motivated to reduce health inequities for our population.”