Faecal immunochemical test for suspected colorectal cancer symptoms: patient survey of usability and acceptability.

Background Recent evidence suggests that the Faecal Immunochemical Test (FIT) can rule out colorectal cancer (CRC) in symptomatic patients. To date, there is no research on usability and perception of FIT for these patients. Aim To measure variation in attitudes and perception of FIT in patients with suspected CRC symptoms. Design & setting Cross sectional survey of a sub-set of participants of the NICE FIT study. Method A questionnaire was co-developed with patients covering four themes: FIT feasibility, faecal aversion, patient knowledge and future intentions, on a Likert scale. Questionnaire and FIT kits were sent to patients with suspected CRC symptoms participating in the NICE FIT study. Logistic regression explored differences in patients’ test perception by ethnicity, language, age, location, deprivation, FIT use and previous experience. Results 1151 questionnaires were analysed; 90.2% of patients found faecal collection straightforward, (95% CI 88.3%–91.8%), 76.3% disagreed FIT was unhygienic (95% CI 73.7%–78.6%), 78.1% preferred FIT to colonoscopy (95% CI 75.6%–80.4%). Preference for FIT over colonoscopy was weaker in patients aged 40–64 than those over 65 years (OR 0.60; 95% CI 0.43–0.84). Intention to use FIT again was stronger in patients who successfully used FIT than those unsuccessful (OR 11.08; 95% CI 2.74–44.75) and white compared to non-white patients (OR 3.20; 95% CI 1.32–7.75). Conclusions While most patients found FIT practical and hygienic, perception differences were found. Strategies to engage patients with more negative FIT perception should underpin symptomatic FIT pathways.