Fecal Colorectal Cancer Screen (FIT)


Sunquest Code:FIT  
Epic Code:LAB4567Epic Name:Fecal Colorectal Cancer Screen FIT
Synonyms:Occult Blood, Stool; Colonl Cancer Screen; Blood, Fecal Immunochemical Test (FIT)
Methodology:Immunochemical
CPT Code:82274
Turnaround Time:Performed and reported 24 hours per day.
Special Instructions:Screening for colorectal cancer; stomach contents or vomitus should be tested using Gastroccult. Urine and excessive dilution of samples with water from the toilet may cause erroneous test results. For best results, use the collection paper in the collection cup or sample directly from stool collected in specimen cup.


Collection Instructions

Specimen:Transport sample bottle with feces sample applied, or fresh feces for inpatients only.
Optimal Volume:Scrape surface of fecal sampling with sample probe from sample bottle and insert sample probe into sample bottle.
Container:Fecal Occult Blood Screening Kit (Plastic leakproof container, sterile)
Collection Instructions:

Outpatient Collection

The fecal occult screening kit has all the necessary items for collection, including directions for specimen collection and application. Instruct the patient to collect a stool specimen on the collection paper inside the toilet bowl on top of water. Use the sample probe to transfer fecal sample to the sample bottle and mail the sample bottle to UMMC in the cardboard mailer. Use only U.S. Postal Service approved mailing pouches included in the kit. The sample bottle containing the collected fecal specimen may be stored up to 15 days at room temperature, 30 days if refrigerated, before testing.

 

Inpatient Collection

Samples should be sent to laboratory immediately for transfer of feces into sample bottle.

 

Patient Preparation:

·          Do not collect samples during or until 3 days after menstrual period, or if hematuria or obvious rectal bleeding, i.e. hemorrhoids are present.

·          Remove toilet bowl cleaners from toilet tank and flush twice prior to specimen collection.

·          Coumadin and other prescription medications are usually not restricted.

 

 

Causes for Rejection:Inoculated sample bottle not received within 15 days of collection if sent at room temperature and 30 days if sent at refrigerated temperature. Sampling bottle used beyond expiration date. Liquid feces. Feces stored in a container other than sampling bottle and transported from locations other than UMMC-University campus.


Processing and Shipping

Specimen Processing:

1.     Open sampling bottle.

2.     Scrape the surface of fecal sample probe.

3.     Cover the grooved portion of the sampling probe completely with stool sample.

4.     Reinsert sample probe into bottle and close tightly.

5.     Label with barcode label.

 

Shipping Instructions:Ship inoculated sampling vial at room temperature; must arrive within 15 days. Alternatively refrigerated to arrive within 30 days of collection.
Test Performed at or Referral Lab Urinalysis  (UMMC-East Bank)


Interpretive

Reference Range:Blood: Negative
Use:Screening test for colorectal cancer. Fecal Immunochemical test (FIT) is more specific for blood originating in the lower GI tract. The presence of blood in the stool is associated with gastrointestinal disorders, such as diverticulitis, polyps, and Crohn's disease, as well as aid in early detection of colorectal center. This addresses many of the weakness of the guaiac test (GT) currently used. The FIT test has superior sensitivity and specificity, a cut off of greater than or equal to 100 ng/mL and a detection rate of 75% for early stage colorectal cancer. The FIT uses antibodies specific for human globulin and unlike the guaiac test, is specific for colorectal bleeding and not affected by diet or medications. There is some evidence that FIT use improves patient participation in screening for colorectal cancer. In 2004, Centers for Medicare and Medicaid Services (CMS) concluded that adequate evidence existed to determine that the FIT is an appropriate and effective colorectal cancer screening test for detecting fecal occult blood in Medicare beneficiaries aged 50 years or greater.


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