Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care

Further research is recommended on how using thresholds higher than 10 micrograms of haemoglobin per gram of faeces to guide referral affects decision making and clinical outcomes.

Further research is recommended on how using dual faecal immunochemical testing (FIT) in primary care (see section 3.10) affects test access, uptake and clinical decision making.

Further research is recommended on the diagnostic accuracy of FIT in people aged under 40 because they may be less likely to have colorectal cancer but more likely to have other bowel conditions such as inflammatory bowel disease (IBD).

Social research is recommended to evaluate methods to improve access, uptake and return of FIT, especially in groups in which engagement is less likely, such as:

• men

• people from ethnic minority backgrounds

• people aged under 40

• people with lower socioeconomic status

• people with physical disabilities, including visual impairment and reduced dexterity

• people with cognitive disabilities or mental health conditions

• neurodivergent people.

Further research is recommended to determine how conditions (such as IBD) or medicines (such as aspirin) that may increase the risk of gastrointestinal bleeding affect the diagnostic accuracy of FIT.

Further research is recommended to assess the effectiveness (including diagnostic accuracy, failure rate and test uptake) of:

• FOB Gold

• IDK Hemoglobin ELISA

• IDK Hemoglobin/Haptoglobin Complex ELISA

• IDK TurbiFIT

• NS‑Prime

• QuikRead go iFOBT.