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Faecal immunochemical test

Faecal occult blood test

The faecal immunochemical test helps to diagnose bleeding disorders of the gut (intestine).

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تابع القراءة أدناه

What is a faecal immunochemical test?

The faecal immunochemical test detects small amounts of blood in your faeces, which you would not normally see or be aware of. Faeces are sometimes called stools or motions. It is the waste that you pass out from your back passage (anus).

There are several disorders which may cause bleeding into the gut (intestine) - for example, gastric أو duodenal ulcers, التهاب القولون التقرحي, bowel polyps و bowel (colorectal) cancer.

Any heavy bleeding into your gut would be obvious because your stools (faeces) would be bloody or a very black colour. However, sometimes there is only a trickle of blood. If you only have a small amount of blood in your stools then the stools look normal. However, the faecal immunochemical test will detect the blood. So, the test may be done if you have abdominal symptoms (tummy) such as persistent pain. It may also be done to screen for bowel cancer before any symptoms develop (see below).

ملاحظة: the faecal immunochemical test can only say that you are bleeding from somewhere in the gut. It cannot tell from which part. If the test is positive then further tests will be arranged to find the source of the bleeding - usually, endoscopy و/أو colonoscopy.

تابع القراءة أدناه

A small sample of stool (faeces) is smeared on to a piece of card. You can obtain the stool sample from stool passed on to layers of toilet paper, into a clean disposable container, or on to a clean disposable glove. It is very important that the stool sample has not come into contact with the water in the toilet. The sample is then sent to a laboratory for testing.

If your test is part of the bowel screening programme, you will be sent a test kit with clear instructions and an envelope to send the sample (within a special test tube) to a laboratory for testing.

Usually faecal immunochemical tests are done on one stool sample. For the faecal immunochemical test, there are no dietary, drug, or dental procedure restrictions.

Screening means looking for early signs of a particular disease in otherwise healthy people who do not have any symptoms and when treatment is likely to be curative. Bowel (colorectal) cancer screening aims to detect colorectal cancer at an early stage when there is a good chance that treatment will cure the cancer.

As colorectal cancer is much more common in older people, the decision has been made for people of a certain age to be invited to participate in the colorectal cancer screening programme. This involves testing three samples of your stools (faeces) for blood. The NHS Bowel Cancer Screening Programme has been introduced in the UK as follows:

  • In England, Wales and Northern Ireland, people aged 60-74 are routinely offered screening every two years.

  • In Scotland, people aged 50-74 are routinely offered screening every two years.

The first test kit should automatically arrive by post within a few weeks after you reach the age at which screening starts. After your first screening test, you will then be sent another invitation and screening kit every two years until you reach the maximum age.

A normal test result is reassuring, but it is a test to look for cancer in people who have no symptoms. If you do have any bowel symptoms, such as a change in bowel habit, persistent loose stools (diarrhoea), tummy (abdominal) pain or weight loss, do not wait for a screening test. Make an appointment to talk to your GP about it.

See the separate leaflet called Screening for Bowel (Colorectal) Cancer.

ملاحظة المحرر

Krishna Vakharia, 12th September 2023

The National Institute for Health and Care Excellence (NICE) has updated its guidance to use faecal immunochemical testing (FIT) to guide referral for suspected bowel cancer as an initial step prior to referral. This is because the evidence shows that offering the test in primary care can identify people who are most likely to have bowel cancer. These people can then be prioritised for referral to secondary care, while people who are less likely to have bowel cancer can avoid unnecessary investigations.

The test will be offered to all adults with:

  • An abdominal mass, or

  • A change in bowel habit, or

  • Iron-deficiency anaemia, or

  • Aged 40 and over with unexplained weight loss and abdominal pain, or

  • Aged under 50 with rectal bleeding and either unexplained abdominal pain or weight loss, or

  • Aged 50 and over with unexplained rectal bleeding, abdominal pain or weight loss, or

  • Aged 60 and over with anaemia even in the absence of iron deficiency.

Furthermore, FIT will be offered even if there has been a previous negative FIT result through the NHS bowel screening programme.

Importantly, people with a rectal mass, an unexplained anal mass or unexplained anal ulceration do not need to be offered FIT before referral is considered- this will avoid any delay in getting seen by a specialist.

If the FIT result is high- adults will be referred for a 2 week wait, suspected colorectal cancer appointment using the local suspected cancer referral pathways.

For those people who have not returned the sample or who have a low FIT result:

  • The doctor will discuss what symptoms to look out for and when to ask for help.

  • Referral should not be delayed if the doctor has a strong concern of cancer due to unexplained symptoms.

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NHS screening programme

الفحوصات والتحقيقات

NHS screening programme

Screening involves tests on people without symptoms to check if they have a disease or condition before it causes symptoms. The reason for screening is the expectation that a problem can be discovered in the early stages and either prevented from progressing further or treated before they cause significant problems. Not all conditions have suitable tests which allow them to be detected early, and not all conditions can be treated successfully even if they are picked up early on. Therefore, only certain conditions are part of our national screening programmes. The screening programmes currently available in the UK are listed below.

بقلم الدكتورة فيليبا فينسنت، MRCGP

فحص عنق الرحم

الفحوصات والتحقيقات

فحص عنق الرحم

A note on terminology - cervical screening is available to those of the female sex, and this leaflet will therefore use the words woman/women and the pronouns she/her. The information also applies to those whose gender identity is not the same as their biological sex, as long as they have not had their cervix surgically removed. Cervical screening tests (smear tests) are available to women aged 25-64 years in the UK. The tests are done to prevent cervical cancer by finding abnormalities that can, with relatively simple treatments, be prevented from progressing to cervical cancer. Cervical screening tests are not used to diagnose cancer.

بقلم الدكتورة توني هازيل، MRCGP

قراءة إضافية ومراجع

تابع القراءة أدناه

About the author

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الدكتور كولين تايدي، MRCGP

General Practitioner, Medical Author

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.

About the reviewerView full bio

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الدكتورة هايلي ويلاسي، زميلة الكلية الملكية للأطباء العامين

General Practitioner, Medical Author

MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)

Dr Hayley Willacy was an NHS GP working in northwest England, who retired from clinical practice in 2022 after 30 years. 

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