# Faecal immunochemical test (FIT)

Source: https://onco.cc/terms/fit-test/  
OnCo record `fit-test` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A stool test for hidden blood, done at home every year. Positive results are followed by colonoscopy.

## Summary

The faecal immunochemical test is an antibody-based assay that detects human haemoglobin in a stool sample collected at home, and a positive result is followed by colonoscopy. Its sensitivity for cancer in a single round is moderate and it detects few adenomas, but when offered every year within an organised programme its modelled benefit approaches that of colonoscopy screening. It is the backbone of most European and Asian colorectal screening programmes and appears alongside the newer stool DNA tests Cologuard and Cologuard Plus and their BLUE-C and DeeP-C trials. Readers also meet it in the colorectal screening technology record, the NordICC and Minnesota trials, the record on Dame Deborah James, and the bottleneck on cancers found late.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Notes

- Two thresholds, one test. England's screening programme calls a person for colonoscopy at 120 micrograms of haemoglobin per gram of faeces; NICE NG12 (1.3.2) refers a symptomatic person in primary care at 10 micrograms per gram. The gap reflects the different pre-test probability and the colonoscopy capacity each pathway can absorb, not a different assay.
- Modelling of the English pilot (27,238 people aged 59 to 75) estimated that two-yearly screening at 120 micrograms per gram generates 16,092 colonoscopies, prevents 186 cancers and detects 1,142 cancers, 7,086 adenomas and 4,259 advanced adenomas per 100,000 people screened over fifteen years; raising the threshold to 180 would need 11,500 colonoscopies and prevent 131 cancers, and a three-yearly interval 10,283 and 126 (Br J Cancer 2022).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Fecal_immunochemical_test
- Wikipedia: https://en.wikipedia.org/wiki/Fecal_immunochemical_test
- GOV.UK: NHS bowel cancer screening programme overview (target population and the screening test): https://www.gov.uk/guidance/bowel-cancer-screening-programme-overview
- Br J Cancer 2022: interscreening interval and faecal immunochemical test threshold in the English bowel cancer screening programme (FIT pilot): https://doi.org/10.1038/s41416-022-01919-y
- NICE NG12: suspected cancer, recommendations by site (lower gastrointestinal tract 1.3.1 to 1.3.5): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Early-onset colorectal cancer (under 50)](https://onco.cc/cancers/early-onset-colorectal/)
- technologies: [Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)](https://onco.cc/technologies/colorectal-screening/), [Multitarget stool RNA test (ColoSense)](https://onco.cc/technologies/multitarget-stool-rna-test/)
- terms: [Faecal occult blood test (guaiac)](https://onco.cc/terms/faecal-occult-blood-test/), [Interval cancer](https://onco.cc/terms/interval-cancer/), [NHS bowel cancer screening programme](https://onco.cc/terms/bowel-cancer-screening-uk/), [Screening uptake](https://onco.cc/terms/screening-uptake/), [Surveillance intervals after polypectomy](https://onco.cc/terms/colonoscopy-surveillance-intervals/)
- institutions: [Bowel Cancer UK](https://onco.cc/institutions/bowel-cancer-uk/)
- trials: [BLUE-C](https://onco.cc/trials/blue-c/), [DeeP-C](https://onco.cc/trials/deep-c/), [Funen faecal occult blood screening trial](https://onco.cc/trials/funen-fob/), [Minnesota Colon Cancer Control Study](https://onco.cc/trials/minnesota-fob/), [NordICC (Nordic-European Initiative on Colorectal Cancer)](https://onco.cc/trials/nordicc/), [Nottingham faecal occult blood screening trial](https://onco.cc/trials/nottingham-fob/)
- key papers: [Minnesota trial: a yearly stool blood test cuts bowel cancer deaths by a third](https://onco.cc/key-papers/paper-minnesota-fobt-nejm-1993/), [Multitarget stool DNA testing for colorectal-cancer screening](https://onco.cc/key-papers/paper-imperiale-multitarget-stool-dna-screening-nejm-2014/), [NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected](https://onco.cc/key-papers/paper-nordicc-nejm-2022/), [Randomised controlled trial of faecal-occult-blood screening for colorectal cancer (Nottingham)](https://onco.cc/key-papers/paper-hardcastle-nottingham-faecal-occult-blood-lancet-1996/), [Randomised study of screening for colorectal cancer with faecal-occult-blood test (Funen)](https://onco.cc/key-papers/paper-kronborg-funen-faecal-occult-blood-lancet-1996/)
- roadmaps: [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/)
- ideas: [Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model](https://onco.cc/ideas/idea-crc-screening-uptake-and-age-extension/), [UK gap: match endoscopy capacity and quality to the faecal immunochemical test thresholds the NHS has already set](https://onco.cc/ideas/idea-crc-uk-colonoscopy-capacity-and-fit-threshold/), [UK gap: shorten the route to diagnosis for patients below the screening age, where the rise in incidence is](https://onco.cc/ideas/idea-crc-uk-young-patient-referral-and-diagnostic-interval/)
- people: [Dame Deborah James](https://onco.cc/people/deborah-james/)
- bottlenecks: [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- drugs: [Cologuard](https://onco.cc/drugs/cologuard/), [Cologuard Plus](https://onco.cc/drugs/cologuard-plus/)

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