The FIT for Symptomatic pathway is in place across the Waikato.
This clinical pathway, developed in 2024 following a successful 2022–23 pilot, will be rolled out to additional districts in the coming months.
Why the pathway is being introduced
FIT, when used alongside clinical assessment, helps prioritise patients for colonoscopy and supports early bowel cancer diagnosis. It can also identify patients for whom colonoscopy may not be required.
The FIT for Symptomatic threshold for a positive result is ≥50 ng Hb/ml buffer, lower than the National Bowel Screening Programme (NBSP) threshold of ≥200 ng Hb/ml buffer.
A lower threshold means the test can detect bowel cancer risk earlier and guide who should be fast-tracked for urgent colonoscopy.
Patients with symptoms should still be offered a FIT for Symptomatic test, even if they’ve previously had a negative NBSP FIT result.
Key benefits
Enables faster assessment and prioritisation for those most at risk.
Provides a less invasive, home-based testing option.
What Waikato practices need to do
Advise patients they are being referred for a bowel assessment and may be offered a FIT test.
Provide the patient information sheet (available on HealthPathways), confirm their address, and note any support needs on referral.
Encourage follow-up for patients who receive a negative FIT result but continue to have symptoms.
Consider contacting FIT-negative patients after six weeks to ensure ongoing symptoms are reviewed.
Eligibility
Patients referred with bowel symptoms who would usually be referred for colonoscopy will be triaged through standard processes and assessed for FIT eligibility. Patients already on the non-urgent colonoscopy waitlist may be contacted to undertake the FIT test if appropriate.
Referral criteria
There are no changes to existing colonoscopy referral criteria. FIT is intended for patients who meet current referral criteria and would usually proceed to a non-urgent colonoscopy.
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