Fecal Immunochemical Testing

Fecal Immunochemical Testing (FIT)

Screening with the fecal immunochemical test (FIT)

  • FIT is a more sensitive screening test than the fecal occult blood test (FOBT), which was previously used in Ontario for average risk colon cancer screening. Because FIT is a more sensitive screening test, it is better at detecting colon cancer and some pre-cancerous polyps than FOBT.
  • Tools and resources can be found on the FIT Resource Hub.

Ordering the fecal immunochemical test (FIT) for a screening participant

  • FIT kits can ONLY be requested for eligible, average risk people by completing the new Cancer Care Ontario FIT Requisition. Other laboratory requisitions will NOT be accepted.
  • It is critical that participant demographic information (name, address, date of birth) is checked by the ordering provider before submitting the requisition form to LifeLabs.
  • Completed requisitions must be submitted to LifeLabs by fax: 1-833-676-1426
  • LifeLabs will mail FIT kits directly to screening participants. Primary care providers will not maintain an inventory of FIT kits.
  • The FIT requisition is available for easy uploading into all OntarioMD-Certified EMRs. Email support@ontariomd.com for support if required.

Abnormal fecal immunochemical test (FIT) results

  • Screening participants with an abnormal FIT result should have a colonoscopy within 8 weeks of their abnormal result.
  • Timely follow-up of an abnormal FIT result is particularly important due to the high likelihood of abnormal findings for follow-up colonoscopies after an abnormal FIT result.
  • Screening participants with an abnormal FIT result should be referred for colonoscopy to a facility that has the expertise and resources to perform colonoscopies in people with an abnormal FIT result (see below for more details).
  • A list of facilities funded by Cancer Care Ontario to provide colonoscopies for patients with an abnormal FIT result is available at cancercareontario.ca/FITcolonoscopy. In the Toronto Central LHIN these are available under Diagnosis and Management.
  • Laboratory providers will continue to test ColonCancerCheck FOBT kits until December 23, 2019. This will allow participants time to complete and return their test if they received an FOBT before FIT was available. After this date, completed tests will be rejected and participants will need to complete a FIT.
  • Participants with an indeterminate or rejected FOBT result will receive a letter instructing them to complete a FIT. Primary care providers will need to submit a FIT requisition to LifeLabs for these participants to receive a FIT kit.