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Early colon cancer screening test for average-risk patients temporarily suspended

October 3, 2017
Vancouver — Fecal immunochemical testing, or FIT, part of the early screening process for colon cancer, has been suspended temporarily for BC residents to ensure tests meet performance standards.

All lab providers in BC have suspended testing after identifying a manufacturer problem with the liquid solution used to test the FIT samples, also known as a reagent.

“Patient safety and quality of care are our top priorities,” said Dr. John Spinelli, vice-president of population oncology at BC Cancer Agency. “We’re exercising an abundance of caution to ensure that British Columbians receive a screening test that performs as expected.”

FIT is a routine screening test recommended for men and women between the ages of 50 and 74. It detects blood in the stool, which can be an early sign of colon cancer. Patients with abnormal test results are referred for a follow-up colonoscopy.

“Patients with a family history of colon cancer or with symptoms that may indicate cancer will not be affected by this test suspension,” said Spinelli. “FIT is designed for people considered at average risk of colon cancer. If you are at high risk of colon cancer due to a strong family history or personal history of adenomas, your doctor can still refer you to the Colon Screening Program for colonoscopy. If you are experiencing symptoms, please speak with your primary care provider, who will work to ensure you get the care you need.”

Symptoms or factors that put people at greater risk of colon cancer include:
• One first degree relative (mother, father, sister, brother, daughter or son) with colon cancer diagnosed under the age of 60; or
• Two or more first degree relatives with colon cancer diagnosed at any age; or,
• A personal history of adenomas.
Colonoscopy for patients who require it is still available province-wide.

The lab providers are working to resolve this temporary suspension as quickly as possible and will have a better idea of timing in the next few weeks; however, early estimates indicate that it could take a number of months for FIT testing to resume.

Patients with a requisition for a FIT will not receive a collection kit until testing resumes. If patients have already submitted a specimen, it will be disposed of safely. Patients who have recently submitted tests to a laboratory, but have not yet received results, will need to be retested, once testing resumes. Patients who recently received a positive result should continue to follow the steps outlined in their notification. A positive result does not necessarily mean a cancer diagnosis and next steps, including referral for colonoscopy, can be discussed with a primary care provider. People who received notification of a negative result will receive a reminder about retesting at the appropriate time.

The Colon Screening Program is committed to providing the public with up to date information on the program. Visit www.screeningbc.ca/colon to review our frequently asked questions and to find out when testing will once again be available.

The BC Cancer Agency, an agency of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. For more information, visit www.bccancer.ca or follow us on Twitter @BCCancer_Agency.

The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us on Twitter @PHSAofBC.

For more information or to arrange an interview:

  PHSA Media Line: 778-867-7472 


Colon Screening Program:
Labs Suspending Fecal Immunochemical Test (FIT) Testing


1. Why am I not able to get a FIT kit for screening right now?
 • All lab providers in BC have suspended Fecal Occult Blood testing using the fecal immunochemical test (FIT) due to a manufacturer reagent problem.
 • The reagent is a liquid solution that is used in the testing of FIT samples.

2. How long will the test be unavailable?
 • We are working to resolve this as quickly as possible and will have a better idea of timing in the next few weeks; however, early estimates indicate that it could take up to six months or longer for FIT testing to resume.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

3. I recently submitted my FIT to the lab but have not received my results. When will my results be available?
 • If you have not received the result of your test, it is likely that the lab has not been able to perform the test on your specimen.
 • You will need to repeat the FIT once testing is available again in BC.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

4. I have a requisition from my doctor to complete the test. What should I do?
 • Keep your requisition and bring it to the lab to get your FIT kit once testing resumes in BC.
 • If there are other tests recommended for you on the requisition you should go to the lab to have those tests complete.
 • You will not be given a FIT kit at this time.
 • The lab will provide you with a copy of the requisition for you to bring back to pick up a kit once testing is available in BC again.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

5. I’m a GP. What should I tell my patients?
 • You can continue to refer average risk patients for FIT screening using the Standard Outpatient Lab Requisition.
 • If you’ve referred patients for other tests, they can bring the requisition to the lab to have those other tests complete. The lab will provide your patient with a copy of the requisition to bring back to pick up a kit once testing is available in BC again.
 • The Colon Screening Program will communicate with you when FIT is available again.

6. I had a negative FIT result two years ago and am due for re-screening. What should I do?
 • The Colon Screening Program will notify you by mail when the FIT is available.

7. I recently received a positive result letter (blood in my stool) from the Colon Screening Program. What should I do?
 • You should continue to follow the steps mentioned in the result letter. As mentioned in the letter, a positive result means blood has been found in your stool; it doesn’t necessarily mean you have cancer. Your health authority will contact you to discuss your next steps including referral for colonoscopy.

8. I recently received a negative result letter (no blood in my stool) from the Colon Screening Program. What should I do? 
 • If you received a negative result letter (no blood found in your stool) you do not need follow-up at this time. The program will mail you a reminder notification when it’s time for you to re-screen.

9. I recently received a letter telling me I should repeat the test (unsatisfactory result letter) from the Colon Screening Program. What should I do?
 • You should repeat the test when the FIT becomes available in BC again.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

10. When did the issue with the FIT begin? 
 • The issue was identified in September and significant increase in positives results dated back to July.
 • If you recently received a positive result letter (blood in stool) from the Colon Screening Program, you should continue to follow the steps mentioned in the result letter. As mentioned in the letter, a positive result means blood has been found in your stool; it doesn’t necessarily mean you have cancer. Your health authority will contact you to discuss your next steps including referral for colonoscopy.
 • If you received a negative result letter (no blood found in your stool) you do not need follow-up at this time. The program will mail you a reminder notification when it’s time for you to re-screen.

11. I recently received a recall notice from the Colon Screening Program indicating that I’m due for FIT re-screening. What should I do?
 • Your doctor can still refer you for a FIT by providing you a requisition.
 • Keep your requisition and bring it to the lab to get your FIT kit once testing resumes in BC. 
 • If there are other tests recommended for you on the requisition you should go to the lab to have those tests complete.
 • You will not be given a FIT kit at this time.
 • The lab will provide you with a copy of the requisition for you to bring back to pick up a kit once testing is available in BC again.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

12. What should I do if I’ve recently completed a FIT but have not submitted it to the lab?
 • Please dispose of your kit or you can return the FIT to the lab and they will dispose it for you.

13. What if I have a significant family history of colon cancer or a personal history of adenoma(s)?
 • Talk to your doctor about colon cancer screening (through colonoscopy) if you have at least one of the following:
  a. One first degree relative (mother, father, sister, brother, daughter or son) with colon cancer diagnosed under the age of 60; or,
  b. Two or more first degree relatives with colon cancer diagnosed at any age; or,
  c. A personal history of adenomas.
 • Colonoscopy as a screening procedure for colon cancer is still available province-wide.

14. I’m currently experiencing _______ symptoms.
 • Screening is only recommended for people who are not experiencing symptoms of colon cancer.
 • Symptoms can include blood in your stool, abdominal pain, change in bowel habits, or weight loss. If you are experiencing these symptoms, talk to your doctor about the diagnostic testing you may need to determine the cause of these symptoms.

15. I would still like to keep up-to-date with my colon cancer screening. Is there an alternative test available?
 • You should complete the test when the FIT becomes available in BC again.
 • For updates regarding the availability of the test, please visit www.screeningbc.ca/colon or call 1-877-70-COLON (26566).

16. What is the BC Cancer Agency’s role in the Colon Screening Program?
 • The BC Cancer Agency values and relies on the partnership with primary care providers, health authorities and labs to deliver the Colon Screening Program:
  a.The BC Cancer Agency Colon Screening Program has responsibility for:
   i.  developing provincial policies and program standards for screening
   ii. patient FIT result notification (normal or notification for further follow up)
   iii.recalling patients for re-screening or surveillance
   iv. facilitating referrals to health authorities for patients who need pre-colonoscopy assessment
   v. monitoring screening program performance and outcomes
  b. Regional Health Authorities have responsibility for capacity planning and service delivery for pre-colonoscopy assessment, colonoscopy and pathology.
  c. Primary Care Providers have responsibility for identifying eligible patients for screening and ordering fecal immunochemical tests (FIT) or referring high risk patients for colonoscopy.
  d. Public and private laboratories within health authorities across BC are responsible for providing FIT kits to patients, and analyzing and reporting FIT results to physicians, nurse practitioners and the screening program.

Physicians and Laboratory staff: Memorandum - Fecal Occult Blood Testing Suspended