Barriers and facilitators to faecal immunochemical testing (FIT) in symptomatic populations: protocol for scoping review

Colorectal cancer (CRC) is the fourth most common cancer in the UK, and the second leading cause for cancer related deaths. An expedited diagnosis and early treatment of CRC improves survival and cure rates, with 95% of patients diagnosed at stage 1 surviving five years or more, compared with only 10% diagnosed at stage 4.

The faecal immunochemical test (FIT) is a non-invasive, dipstick test that detects the early degradation products of blood in the faeces. It is now widely used as a surrogate marker for bowel cancer, and used in primary care for assessment of both symptomatic and asymptomatic (bowel cancer screening) individuals.
Previous research suggests that up to 10% of FIT samples are not returned by patients after being given out by GPs. This can lead to diagnostic delays, with recent modelling research demonstrating that a 2 month diagnostic delay can lead to a >9% reduction in 10-year survival.

The aim of this review is to characterise the literature on the facilitators and barriers to FIT testing in the context of the NHS in the UK and other countries with comparable healthcare systems in symptomatic populations.

The specific objectives are:
- Systematic searches and selection of studies on the facilitators and barriers to FIT testing in the context of the NHS in the UK and other countries with comparable healthcare systems in symptomatic populations.
- Charting of data from eligible studies
- Narrative, tabular and graphical syntheses
- A gaps analysis showing research priorities