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Important Fecal Occult Blood Testing Notice

All lab providers in BC for Fecal Occult Blood testing using Fecal Immunochemical Testing (FIT) are experiencing an issue affecting the accuracy of the test results.

The percentage of positive results is increasing suggesting that some borderline negative patients are now testing positive.

It is estimated that this change in the measurements will affect some patients tested i.e. they will now have a screen positive result whereas previously they would have had a borderline negative result.

Healthcare providers should interpret the borderline positive results accordingly when deciding to refer screen-positive patients for colonoscopy, although colonoscopy is medically justified in all screen positive patients.

While the positive predictive value of FIT screening may be lower than it has been in the past, a positive FIT still places the patient at higher risk. The Colon Screening Program recommends colonoscopy follow-up for all screen-positive cases.

The Colon Screening Program does not recommend ordering another FIT as it is not possible to know if a subsequent negative result is due to a test issue versus intermittent bleeding of polyps. Follow-up colonoscopy is recommended even if a patient has another FIT that is negative.

Patients refereed to Colon Screening Program who have had a positive test result will continue to be referred to their Health Authority for pre-colonoscopy assessment.

What this means:

Until further notice FIT results will be reported with the following comment advising patients and healthcare providers about the issue.

 

BC laboratories are experiencing an issue with FIT results. The percentage of positive results is increasing suggesting that some borderline negative patients are now testing positive. Interpret accordingly when deciding to refer for colonoscopy in your screen-positive cases, although colonoscopy is medically justified in all screen positive patients.

We are working to resolve the issue and will provide updates as appropriate. For more information visit LifeLabs.com, screeningbc.ca/colon or your health authority's website. ​

Frequently Asked Questions

1)    What is the FIT Test and what is it used for?

  • The Fecal Immunochemical Test (FIT) measures the amount of blood in your stool sample. A positive (abnormal) result means that blood was found in your stool.  Blood in the stool suggests an individual is at higher risk for having colon cancer.
  • FIT is recommended as a screening test every two years for those ages 50-74 who are of average risk to develop colon cancer.
  • If you have a positive FIT result, the Colon Screening Program recommends that you have follow-up colonoscopy. Patients with positive FIT results who have their FIT result registered in the Program will automatically be referred to their Health Authority for a pre-colonoscopy assessment.
  • A positive FIT result is common.  More than 15 per cent of people test positive and are referred for colonoscopy.  A positive result does not mean that cancer was found.  As patients with a positive result are at greater risk for colon cancer, it is important to attend to follow-up procedures.

2)    My FIT result has a statement that there are issues with the test. What does it mean?

  • All lab providers in BC using Fecal Immunochemical Testing (FIT) are experiencing an issue affecting the accuracy of the test results.
  • The percentage of positive results is increasing suggesting that some borderline negative patients are now testing positive
  • If you have questions about whether you should or should not proceed to colonoscopy, speak with your health care provider. Those with a negative FIT result will be reminded to rescreen in two years.
  • Speak with your health care provider if you are currently experiencing symptoms of colon cancer: visible blood in your stool, abdominal pain, a change in bowel habits or unexplained weight loss.

 

3)    I'm due for rescreening. Should I take the FIT at this point in time?

  • Yes, if you are due for rescreening, please see your health care provider for a requisition to pick up your FIT. Anyone ages 50-74 should screen for colon cancer every two years with the FIT.

4)    I recently received a positive (abnormal) FIT and was referred for colonoscopy. However, I repeated my FIT and received a negative result. Does this mean that I don't need a colonoscopy?

  • The Colon Screening Program recommends that all positive FIT results be followed-up with colonoscopy. Even if the second test is normal, the Colon Screening Program recommends follow-up colonoscopy.
  • No screening test is perfect. Some polyps and/or cancers may have been bleeding at the time of the first FIT but not bleeding when you took the second FIT. Or, the second sample (the negative result) was taken from a part of your stool that had a lesser amount or no blood.

5)    I'm a GP/Healthcare Practitioner. I am receiving test results with a notification.   What should I know?

  • All lab providers in BC for Fecal Occult Blood testing using Fecal Immunochemical Testing (FIT) are experiencing an issue affecting the accuracy of the test results.
  • The percentage of positive results is increasing suggesting that some borderline negative patients are now testing positive.
  • It is estimated that this change in the measurements will affect some patients tested i.e. they will now have a screen positive result whereas previously they would have had a borderline negative result.
  • While the positive predictive value of FIT screening may be lower than it has been in the past, a positive FIT still places the patient at higher risk. The Colon Screening Program recommends colonoscopy follow-up for all screen-positive cases.
  • The Colon Screening Program does not recommend ordering another FIT as it is not possible to know if a subsequent negative result is due to a test issue versus intermittent bleeding of polyps. Follow-up colonoscopy is recommended even if a patient has another FIT that is negative.
  • Patients referred to the colon screening program who have had a positive test result will continue to be referred to their Health Authority for pre-colonoscopy assessment. Please continue to communicate that this result is common (more than 15 per cent require further testing) and that it does not mean that cancer was found.
  • The Colon Screening Program does not recommend patients complete a guaiac-based FOBT instead of FIT.

6)    Why are you continuing testing?

  • FIT is an important screening test for colon cancer. Despite the current issue with the FIT test, it still identifies those individuals with a relatively high concentration of blood in their stool, an early warning sign of colon cancer.
  • Colon cancer is one of the most commonly diagnosed forms of cancer, affecting 1 in 6 people in British Columbia. In its early stages, there are often no symptoms- which is why screening is so important. 

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