Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK
Objectives Faecal immunochemical testing (FIT) is now commonplace in the UK to prioritise symptomatic patients for urgent gastrointestinal investigation. The test requires a stool sample to be collected at home by the patient and returned for analysis. In this qualitative study, we sought to underst...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e093215.full |
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| author | Linda Sharp Christian von Wagner Colin J Rees Willie Hamilton David Humes James Turvill Laura Jane Neilson Adam Biran Christina Dobson John Whelpton |
| author_facet | Linda Sharp Christian von Wagner Colin J Rees Willie Hamilton David Humes James Turvill Laura Jane Neilson Adam Biran Christina Dobson John Whelpton |
| author_sort | Linda Sharp |
| collection | DOAJ |
| description | Objectives Faecal immunochemical testing (FIT) is now commonplace in the UK to prioritise symptomatic patients for urgent gastrointestinal investigation. The test requires a stool sample to be collected at home by the patient and returned for analysis. In this qualitative study, we sought to understand the feasibility and acceptability of FIT-based triage for patients.Design A cross-sectional, qualitative, experiential interview study.Setting Recruitment was through three participating UK NHS sites (Yorkshire, Midlands, North-East). Health professionals were also identified through membership of the BSG/ACPGBI Symptomatic FIT Guideline Development Group and snowball sampling.Participants We interviewed 21 patients who had completed FIT and been referred for colonoscopy and 30 primary and secondary care health professionals involved in symptomatic FIT delivery.Results Completion of FIT was unproblematic from the perspective of patients who returned the test. However, health professionals expressed concern over non-return. Among patients, understanding of the purpose of FIT and the meaning of results varied. Health professionals acknowledged that ensuring patient understanding of these can be challenging. Patients believed colonoscopy was less likely to miss cancer than FIT. Patients with a family or personal history of cancer were particularly anxious and wanted the reassurance of colonoscopy, even with a negative FIT result.Conclusions We found no major barriers to the use of FIT in prioritising symptomatic patients for urgent investigation. Improving communication might increase compliance and, possibly, acceptability of non-referral for colonoscopy in the case of a negative test result. |
| format | Article |
| id | doaj-art-64d303b491d04a1cb9d5cfc563bed5af |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-64d303b491d04a1cb9d5cfc563bed5af2025-08-20T01:51:49ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-093215Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UKLinda Sharp0Christian von Wagner1Colin J Rees2Willie Hamilton3David Humes4James Turvill5Laura Jane Neilson6Adam Biran7Christina Dobson8John Whelpton9Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKDepartment of Epidemiology and Public Health, University College London, London, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKUniversity of Exeter Medical School, Exeter, UKGastrointestinal and Liver Theme, NIHR Nottingham Biomedical Research Centre, Nottingham, UKYork and Scarborough Teaching Hospitals NHS Foundation Trust, York, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKLay Investigator, Newcastle University, Newcastle upon Tyne, UKObjectives Faecal immunochemical testing (FIT) is now commonplace in the UK to prioritise symptomatic patients for urgent gastrointestinal investigation. The test requires a stool sample to be collected at home by the patient and returned for analysis. In this qualitative study, we sought to understand the feasibility and acceptability of FIT-based triage for patients.Design A cross-sectional, qualitative, experiential interview study.Setting Recruitment was through three participating UK NHS sites (Yorkshire, Midlands, North-East). Health professionals were also identified through membership of the BSG/ACPGBI Symptomatic FIT Guideline Development Group and snowball sampling.Participants We interviewed 21 patients who had completed FIT and been referred for colonoscopy and 30 primary and secondary care health professionals involved in symptomatic FIT delivery.Results Completion of FIT was unproblematic from the perspective of patients who returned the test. However, health professionals expressed concern over non-return. Among patients, understanding of the purpose of FIT and the meaning of results varied. Health professionals acknowledged that ensuring patient understanding of these can be challenging. Patients believed colonoscopy was less likely to miss cancer than FIT. Patients with a family or personal history of cancer were particularly anxious and wanted the reassurance of colonoscopy, even with a negative FIT result.Conclusions We found no major barriers to the use of FIT in prioritising symptomatic patients for urgent investigation. Improving communication might increase compliance and, possibly, acceptability of non-referral for colonoscopy in the case of a negative test result.https://bmjopen.bmj.com/content/15/5/e093215.full |
| spellingShingle | Linda Sharp Christian von Wagner Colin J Rees Willie Hamilton David Humes James Turvill Laura Jane Neilson Adam Biran Christina Dobson John Whelpton Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK BMJ Open |
| title | Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK |
| title_full | Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK |
| title_fullStr | Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK |
| title_full_unstemmed | Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK |
| title_short | Patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms: a cross-sectional qualitative interview study with patients and practitioners in the UK |
| title_sort | patient experiences and expectations of faecal immunochemical testing for investigation of colorectal cancer symptoms a cross sectional qualitative interview study with patients and practitioners in the uk |
| url | https://bmjopen.bmj.com/content/15/5/e093215.full |
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