Leanne James, Gina Sanki, John Geen (CTMUHB) and Alistair McLaren (Alpha Laboratories)
Cwm Taf Morgannwg University Health Board and industry partner, Alpha Laboratories
This Bevan Exemplar project, in partnership with Alpha Laboratories, implemented a new laboratory-based technology to guide referral for colorectal cancer in symptomatic adult patients in primary care.
Background
Quantitative faecal immunochemical testing (FIT) has been declared “fit for purpose” by the NICE guidance DG30 for guiding referral for colorectal cancer in symptomatic adult patients in Primary Care.
Aims
The aim of this project was to implement the FIT test in our laboratory to identify patients in primary care who are unlikely to have significant colorectal disease and would not benefit from colonoscopy referral, potentially saving resources and minimising waiting times. We also wanted to create a pathway for primary care with our gastroenterology colleagues and support patient user documentation for the FIT test.
Challenges
- Local demand and capacity concerns from gastroenterology.
- The need to standardise documentation for all-Wales use.
- Agreement of standardised measurable outcomes for use across Wales, and how to obtain this data reliably.
Outcomes
The HM-JACKarc analyser was implemented and interfaced with the all-Wales laboratory software through to Welsh Clinical Portal and Primary care systems.
The service is provided out of Prince Charles Hospital and has full UKAS accreditation (ISO 15189).
Comprehensive documentation has been produced for use across Wales which includes patient feedback. CTMUHB are currently running pilot FIT samples for Aneurin Bevan University Health Board GP patients and for a research study (CRaFT) based in Swansea.
Next steps
A local pilot will begin soon in Cwm Taf Morgannwg University Health Board and data can be gathered to look at the impact FIT has on earlier detection of bowel cancer and measure the effect on unnecessary colonoscopy procedures.
