Fecal Immunochemical Test

Ontario is switching from the guaiac fecal occult blood test (gFOBT) to the fecal immunochemical test (FIT) as of June 24, 2019.

Why? The FIT is a more sensitive screening test than the gFOBT, which means that it is better at detecting colorectal cancer and high-risk adenomas.

The FIT is specific for human hemoglobin, which means it will not mistake dietary sources of blood or other substances for human blood.

The benefits of FIT include:

  •  the enhanced design of the collection device, which is easy to use and reduces the amount of contact people have with their stool when collecting it;
  • only one specimen is needed;
  • no dietary restrictions
  • no medication restrictions

Why should average-risk people be screened by the FIT over colonoscopy?

  • The ColonCancerCheck program does not recommend screening with colonoscopy for people at average risk.
  • Unlike colonoscopy, FIT is non-invasive.
  • Colonoscopy remains the appropriate test for follow-up of abnormal FIT results and for screening people at increased risk of colorectal cancer.

How do I receive the FIT?
After meeting with you to discuss the test, your doctor will send a lab requisition to LifeLabs indicating that you are due for colorectal cancer screening. Lifelabs will then mail you a FIT kit. The kit will include the FIT collection device, simple picture-based instructions for completing the FIT, and materials for mailing it back to LifeLabs. Copies of the FIT instructions can be found at: www.cancercareontario.ca/FIThub

How do I return the FIT?
You must return the completed FIT to LifeLabs by mail or by dropping it off at a specimen collection centre associated with LifeLabs (www.locations.lifelabs.com). The completed FIT should be returned to LifeLabs as soon as possible after the stool is collected. LifeLabs will contact you if your specimen collection date needs clarification. You only have to return the completed FIT with the specimen collection date clearly recorded in the space provided. No additional paperwork has to be returned with the completed FIT.

How to I receive my results?
Your doctor will receive results directly from LifeLabs. If your results are abnormal, your doctor will contact you and arrange for timely follow-up with a colonoscopy. You will also receive a results letter from Cancer Care Ontario, including guidance on what to do next. For example, patients with normal FIT results will receive a letter letting them know that no further action is needed, and that they will be recalled to screen with FIT again in two years. Patients with an abnormal FIT result will receive a letter instructing them to follow up with their family doctor, explaining that the doctor will recommend a follow-up colonoscopy. Repeating the FIT after an abnormal FIT is not appropriate and can lead to delays in diagnosis and treatment of potentially serious health concerns.