Faecal immunochemical test-based prediction tools

Topic Status Complete

Faecal immunochemical test-based prediction tools for the assessment of people presenting to primary care with symptomatic bowel disease.

Outcome of the appraisal


The evidence supports the adoption of FIT to guide the referral of patients with lower gastrointestinal symptoms for colonoscopy. The use of the FIT-based prediction tools FAST and COLONPREDICT shows promise but the incremental benefits as compared with FIT alone are uncertain from the evidence currently available.

HTW therefore supports the adoption of FIT as recommended by NICE Diagnostic Guidance 30 but proposes that a prospective and structured evaluation of the clinical and cost benefits of combining FIT with the prediction tools FAST and COLONPREDICT be incorporated into the implementation strategy in NHS Wales.

Why was this topic appraised?


The majority of colorectal cancer cases are diagnosed through GP referral. NICE Diagnostics Guidance 30 recommends faecal immunochemical tests (FITs) to guide referral of symptomatic patients in primary care who do not meet the referral criteria for suspected cancer referral (NICE guideline 12). FIT-based prediction tools could help optimise referral for colorectal cancer investigations, reducing unnecessary colonoscopies.

Lay summary


This is the lay summary.

Topic Exploration Report

TER011 (08.2018)

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Evidence Appraisal Review

EAR007 (01.2018)

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GUI007 (02.2018)

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