Quantitative Faecal Immunochemical Test (QFIT)

What is a QFIT Test?

The Quantitative Faecal Immunochemical Test, referred to as the QFIT test, is a stool (faeces or poo) test. QFIT detects tiny amounts of blood in the stools (faeces or poo), known as faecal occult blood. It does this by detecting specific antibodies in the blood and so provides a very definite result.

The QFIT test is designed to recognise potential signs of bowel disease, specifically bowel cancer and non-cancerous or precancerous tumours. It is particularly useful because a bowel that is abnormal, such as those with lesions that are early signs of cancer, is more likely to bleed than a normal bowel. The test does not diagnose a disease or cancer, it identifies that there is a bleed only; other tests are needed to identify the cause of the bleed.

Can I get a QFIT Test?

The Online Clinic can provide a postal QFIT test, with results interpreted by a doctor. The results take 1 day from the time the sample is received.

Why is a QFIT Test important?

The QFIT test is used for people with symptoms of bowel disease such as bleeding from the rectum. When the bowel is normal, there will be too little blood loss from the digestive tract and seen in the stool to be noticeable or detected by the QFIT test. Anyone with symptoms of possible bowel disease including cancer, such as a significant or an obvious amount blood (red or dark) in the stool, is usually asked to do a QFIT test. The test is usually done before referral for further investigations, such as colonoscopy.

The QFIT test is also used to screen people who do not have bowel symptoms but are at high risk of developing bowel disease. It is mainly used to screen for bowel cancer (colorectal cancer) because early detection of symptoms, before the cancer spreads, increases the chances of its successful treatment.

A national bowel cancer screening programme is in place in the UK and so you may be invited to take the test as part of this programme.

Who should have a QFIT test?

Your doctor may ask you to complete a QFIT test if you have lower abdominal symptoms, including blood in your stools, a change in bowel habit to either diarrhoea or constipation, abdominal pain, anaemia, a lump in the abdomen or rectum, and/or unexplained weight loss.

Patients can request a private QFIT test if they do not qualify for one on the national screening programme.

How to take a stool sample for QFIT testing?

The QFIT test requires a sample of your stool that you collect yourself. You can collect your sample at any time of day and do not have to stop any medicines or foods beforehand, although women should avoid the time of a menstrual bleed.

The QFIT test provides everything needed for sample collection along with instructions on how to collect the sample - please read these instructions before you start. To summarise, the labels are completed and stuck on the collection tube before stool sample collection. To collect your stool sample, place toilet paper in the toilet bowl, and poo on the toilet paper (try to keep the poo out of the toilet water). The collection tube lid has an attached sampling stick, and this stick is then scraped over the stool until it is evenly covered with poo. The sampling stick is then placed back inside the collection tube, enabling the tube lid to close the tube. The collection tube is put into the outer sample container, which contains absorbent material, and closed. The sample container along with the request form is put into the test-kit box, which is put into the envelope and posted immediately for analysis.

What do QFIT Test results indicate?

The QFIT test result will determine whether you do or do not have blood in your stool. It is able to rule out or rule in significant diseases of the large intestine (colon and rectum), including colorectal cancer, benign tumours (adenomas) that are high risk of becoming cancerous (e.g., polyps), and inflammatory bowel disease.

The threshold for a positive result may differ between laboratories. A positive test result means that the amount of faecal occult detected is above 10 µg/g. In this case, you have blood in your stool and that there is a risk of bowel disease and cancer. You will likely be referred for further investigations (such as colonoscopy or sigmoidoscopy that examine the colon and rectum) to identify where the bleeding is coming from. A positive test does not automatically mean that you have colorectal cancer.

A negative test result means that the amount of faecal occult detected is below 10 µg/g. In this case, no blood in your stool was detected. While this is reassuring, it is important to know that not all colorectal cancer is detected by the test (because it may not bleed) and so does not mean it is absent. You will likely be asked to do another test at another time, particularly if symptoms persist, as well as receiving information on symptoms to look out for.

Additionally, a negative test does not automatically mean that you do not have another bowel disease and, depending on symptoms, you may be investigated for other intestinal conditions, including haemorrhoids (piles), ulcers, diverticulitis, irritable bowel syndrome and coeliac disease.