My understanding is that means that all GPs will request it (or similar). So they can send it to a local laboratory which can do it on--site or send it away, or they can send it somewhere else.
I suppose it's possible that some of the screening hub laboratories will offer non-screening assays.
Jonathan
On 24 Jun 2015, at 08:53, Patel Bharat (RWG) West Hertfordshire TR <[log in to unmask]> wrote:
> Does this mean all labs to introduce FOB testing?
>
> Bharat
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
> Sent: 23 June 2015 09:34
> To: [log in to unmask]
> Subject: Re: Earlier diagnosis of cancer
>
> ---
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
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> The identified sender is [log in to unmask]
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> Thanks Sally
> Relevant para reprinted below for those who have not downloaded the full guideline.
> Hopefully this test will remain in the bowel cancer screening world, do you see it that way? Or are we back to locally offered FOB's and in that case is it an opportunity to avoid guiac.
> If we were to be pushed down that route my personal view is that the immunological test is a "new test" outside tariff, so maybe we could fully recover the additional costs.
> BW John
>
> "Offer testing for occult blood in faeces to assess for colorectal cancer in adults without rectal bleeding who:
>
> are aged 50 and over with unexplained:
>
> abdominal pain or
>
> weight loss, or
>
> are aged under 60 with:
>
> changes in their bowel habit or
>
> iron‑deficiency anaemia, or
>
> are aged 60 and over and have anaemia even in the absence of iron deficiency. [new 2015]"
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Benton Sally (ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST)
> Sent: 23 June 2015 09:19
> To: [log in to unmask]
> Subject: Re: Earlier diagnosis of cancer
>
> ---
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
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> Hi Jonathon,
>
> In the bowel cancer screening world we are very surprised that this test has still been included and are discussing how to respond.
>
> A number of professional bodies, groups and individuals involved in colorectal cancer responded to the draft guidelines highlighting the deficiencies of the FOB test for diagnosis, particularly due to the high risk of false negative results. The guiaic test is certainly unsuitable diagnostically and there is currently insufficient evidence to support faecal immunochemical testing in this situation. So I'm not sure that producing professional standards for performance of the assay is going to help things at this stage since no matter how well the test is performed it is still likely to generate a result that may lead to the incorrect diagnosis.
>
> Sally
>
>
> Sally C Benton FRCPath
> Consultant Biochemist, Surrey Pathology Services, Royal Surrey County Hospital, Guildford Director, Bowel Cancer Screening Hub - South of England Direct telephone: 01483 409850
> PA: Kate Randall. Telephone: 01483 409854 Postal Address:
> Bowel Cancer Screening Southern Programme Hub Surrey Research Park, 20 Priestley Road Guildford, Surrey
> GU2 7YS
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay
> Sent: 23 June 2015 09:03
> To: [log in to unmask]
> Subject: Earlier diagnosis of cancer
>
> NICE guidance just published on earlier diagnosis of cancer.
>
> There's a big new emphasis on measurement of occult blood (and similar)*. Does the ACB have professional standards for performance of this assay?
>
> Jonathan
>
> * And so soon after we engineered it out of primary care...
>
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