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NICE Committee Recommends Fecal Testing for All Patients With Signs of Colorectal Cancer

NEW YORK — The UK National Institute for Health and Care Excellence (NICE) said on Wednesday that its diagnostic advisory committee has recommended the use of fecal immunochemical tests (FIT) by all people showing signs and symptoms of colorectal cancer.

The recommendation, NICE said, would help reduce the number of unnecessary colonoscopies, cutting waiting times for nonurgent referrals.

Under current NICE guidelines, FIT is offered to some people showing symptoms of colorectal cancer, while others are immediately referred for colonoscopy. The new recommendation calls for all patients with symptoms to receive fecal testing, using either HM-Kyowa-Medex's JACKarc or Eiken Chemical's OC-Sensor. The at-home tests, the agency said, cost around £4 ($5) a sample and can identify nine out of 10 people with colorectal cancer.

FIT's use among all people with signs of colorectal cancer is expected to reduce referrals for urgent colonoscopies by general practitioners in primary care settings by about 50 percent each year, NICE said. The advisory committee noted that doctors should still refer people for colonoscopy even without a positive FIT result if deemed necessary.

"We know the demand for colonoscopies is high, so recommending the use of FIT in primary care could identify people who are most likely to have a condition that would be detected by colonoscopy," Mark Chapman, interim director of medical technology and digital evaluation at NICE, said in a statement. "Introducing FIT to people as an initial test will also mean that those who are unlikely to have colorectal cancer may avoid having a colonoscopy, and those who are more likely to have it can be prioritized."

The advisory committee's recommendation is now under review, NICE said.