Attitudes towards faecal immunochemical testing in patients at increased risk of colorectal cancer

There has been increased interest in using the faecal immunochemical test (FIT) as a rule-out test for patients with high-risk symptoms of colorectal cancer, based on its negative predictive value range of 99.8-100.0%. This cross-sectional survey of GPs in England aimed to investigate GPs’ attitudes and willingness to use a FIT over urgent referral for a colonoscopy. Just over a third of GPs in the sample preferred to use a FIT test to rule-out colorectal cancer. GPs were more willing if they were aged 36-55,  thought patients would benefit compared with having a colonoscopy or were highly confident about discussing the benefits of a FIT. GPs were less willing if they though that longer consultations would be needed. These results suggest that acceptability of using a FIT as a rule-out test is low, with less than half of GPs who perceived the test to be accurate preferring it over colonoscopy. Educational interventions to increase GP confidence in the accuracy are important next steps, as well as addressing implementation issues such as increased consultation times.

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