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Colorectal Cancer Screening

Fecal Immunochemical Test (FIT)

FIT is a safe and painless stool-based test used for screening people at average risk of developing colorectal cancer. FIT checks for the presence of occult blood in the stool, which can be an early sign of colorectal cancer and/or pre-cancerous lesions. When colorectal cancer is found and treated early, the chances of successful treatment are better.

How is the test performed?

A stool sample

As of June 24, 2019, FIT will be the recommended screening test for people at average risk of getting colorectal cancer*. FIT will be available across the province through Cancer Care Ontario’s organized colorectal cancer screening program, ColonCancerCheck.

FIT is a safe and painless stool-based test used for screening people at average risk of developing colorectal cancer. Specifically, FIT checks for the presence of occult blood in the stool, which can be an early sign of colorectal cancer and/or pre-cancerous polyps.

*Average risk is defined as people ages 50 to 74 with no first-degree relative who has been diagnosed with colorectal cancer

Primary care providers can order a FIT kit for eligible, average risk people by completing a FIT requisition.

  • The FIT requisition is a single-test, program-branded requisition
  • FIT cannot be ordered using the Ministry of Health and Long-Term Care Laboratory Requisition or a hospital laboratory requisition

The FIT requisition will be available at cancercareontario.ca/FIThub

Primary care providers can use the FIT requisition to indicate if the FIT kit should be mailed to an alternate address, which may differ from their patient’s primary mailing address (e.g., health centre or nursing station).

Primary care providers are responsible for validating patient address information and date of birth before completing the requisition. This validation is critical to ensure that LifeLabs and ColonCancerCheck have up-to-date participant mailing information so that the privacy of patients is not compromised and participants can receive their FIT kit and test result notification.

Completed FIT Requisitions must be faxed directly to LifeLabs FIT Line or via your electronic medical records after go live on June 23rd.

Primary care providers will not maintain an inventory of FIT kits. Centralized distribution through LifeLabs facilitates inventory management and allows for pre-labeling, which will reduce labeling errors.

If you have not ordered lab tests through LifeLabs previously, or are unsure if you are in the LifeLabs database, please call and give us the following information before you start faxing the FIT requisitions for your patients:

  • Physician billing number (must be an Ontario billing number only)
  • Indicate whether you are a doctor or nurse practitioner
  • Last name
  • First name
  • Full address including – Suite number/Address number/Street/City/Province(ON)/Postal code
  • Phone number
  • Fax number
  • Indicate to us that you’re asking for FIT

You may share this information with us in the following ways:

  • By calling our dedicated FIT Helpline (Ph: 1-833-676-1426)
  • By calling our LifeLabs Customer Care Centre and specifying that you’re registering for FIT (Ph: 1-877-849-3637)

To receive results electronically via your EMR system, please have your EMR vendor contact the LifeLabs IT Service Desk (Ph: 1-800-465-6001)

To get setup with Launchpad, LifeLabs’ 24/7 free physician portal, please register here.

As of June 24, 2019, ColonCancerCheck (CCC) will no longer recommend that people at average risk of colorectal cancer screen with gFOBT. Although there is high-quality scientific evidence to support screening with gFOBT, the fecal immunochemical test (FIT) offers several advantages over gFOBT:

  • Patients prefer FIT because it is easier to use
  • FIT is better at detecting colorectal cancer and pre-cancerous polyps than gFOBT

CCC gFOBT laboratory providers will arrange the removal of unused CCC gFOBT kits from primary care provider offices once FIT becomes available as the recommended screening test for people at average risk of getting colorectal cancer. Primary care providers should not distribute unused CCC gFOBT kits once FIT becomes available.

CCC gFOBT laboratory providers will continue to test CCC gFOBT kits for six months after FIT becomes available as the recommended screening test for people at average risk of getting colorectal cancer. This will ensure that most participants who complete their CCC gFOBT kit after FIT becomes available can still receive their CCC gFOBT result.

 CCC gFOBT kits returned after six months will be rejected by CCC gFOBT laboratory providers. Primary care providers will be notified if a CCC gFOBT kit is returned from a patient beyond six months from when FIT becomes available.

For a comprehensive list of gFOBT decommissioning frequently asked questions, visit: cancercareontario.ca/FIThub

Laboratory reports to providers include standard messaging for fecal immunochemical test (FIT) results and recommended next steps. FIT results are reported qualitatively as normal, abnormal, invalid or rejected.

If the result is normal, patients should be re-screened with FIT in two years if they continue to meet the ColonCancerCheck eligibility criteria for average risk colorectal cancer screening.

If the result is abnormal, patients should be referred to colonoscopy as soon as possible. The colonoscopy should be completed within eight weeks of the abnormal FIT result.

If the result is invalid* or the FIT collection device is rejected**, the report will provide the specific reason for the unsatisfactory test result. Primary care providers should promptly submit a new FIT requisition for their patient and counsel them if they need help completing their next test successfully.

*Invalid FIT result: The FIT collection device was tested but a valid result could not be obtained (e.g., too much sample or result below the positivity threshold with no specimen collection date).

**Rejected FIT collection device: The FIT collection device was not accepted for testing by LifeLabs (e.g., specimen leaking, FIT collection device not opened).

Our medical experts and account managers are available to support you in selecting the appropriate tests and services for your practice. LifeLabs offers pathology services, general and advanced diagnostics, genetics testing and mobile laboratory services.

Consultations with our experts are available upon request. Request a medical consultation.

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