25 May 2021
by Paul Thomas, Michael Wallage, Ellen Roberts

Effect of the COVID-19 Pandemic on Faecal Immunochemical (FIT) Testing in the SWAG Cancer Alliance

Paul Thomas, Michael Wallage & Ellen Roberts

Effect of the COVID-19 Pandemic on Faecal Immunochemical (FIT) Testing in the SWAG Cancer Alliance

Paul Thomas, Michael Wallage and Ellen Roberts

Severn Pathology, Southmead Hospital

Severn Pathology had been commissioned by the SWAG Cancer Alliance (Somerset, Wiltshire, Avon and Gloucester) to provide a FIT testing service for patients at low risk of bowel cancer. This was provided by direct distribution of packs to GPs, samples were posted to the laboratory and results returned electronically to the GP.  Following the development of the COVID pandemic in early 2020 work load initially decreased by approximately 50% to less than 500 samples in April as patients failed to attend their GPs recovering in June.  Workload continued to increase to three times pre-COVID levels with more than 3000 samples in November.  Increased workload put pressure on sample reception when staff numbers were reduced and social distancing was required.  Logistics, supply chain management and pack distribution became a significant pressure.   Workload increased due to catch up of unseen patients and expansion of testing criteria to include higher risk patients due to reduced endoscopy capacity.  Previously testing had been restricted to patients >50 years but now includes “aged over 18 with change in bowel habit or other symptoms that could be caused by colorectal cancer but are low risk”.  Analysis showed 6% of tests were carried out in patients between 18-50 years. FIT testing was also provided to hospitals within the SWAG area to triage patients referred on 2WW pathways to mange endoscopy capacity.  This required customisations of the service delivery model to meet local hospital needs with 1714 patients tested by November.  Overall the % rate of positive FIT tests has remained constant at approximately 18% and is very similar in primary and secondary care suggesting patients considered low risk may have a similar risk to patients previously referred on a 2WW pathway.  Expanded FIT testing is likely to remain in place as it is predicted to reduce endoscopy numbers.

Related topics

Authors

Paul Thomas

Consultant Clinical Scientist, Severn Pathology, Southmead Hospital, Bristol

Michael Wallage

Severn Pathology, Southmead Hospital, Bristol

Ellen Roberts

Severn Pathology, Southmead Hospital, Bristol