Lower GI Pathway and 2WW Lower GI - Urgent Suspected Cancer and FIT
High Risk Lower GI
- Lower GI 2WW Referral form (If positive FIT test the GP would need to complete this 2WW referral form)
Low Risk Lower GI
FIT Faecal Immunochemical Test
- Key things to know about FIT
- Practical delivery of the FIT Test
- Introduction of FIT
- Patient information leaflet
To support timely triage and investigation of patients referred on the Lower GI Urgent Suspected Cancer (USC) pathway, please ensure referrals include:
- FIT result
- FBC, Ferritin and U&Es (within 3 months)
- Relevant symptoms, examination findings and clinical history
- Confirmation the patient has been informed of their USC referral
- WHO Performance Status where available
The regional Lower GI pathway recommends that patients should generally have a FIT result ≥10 µg before referral onto the USC pathway. Patients with FIT <10 or no FIT will normally be managed outside the USC pathway unless an exception applies (e.g. anal/rectal mass or ulceration, or prior agreement through Advice & Guidance).
Barnsley Hospital recognise that access to phlebotomy and diagnostics can sometimes delay results. Where there is significant clinical concern, referrals should not be unnecessarily delayed. Please submit the referral with available information, indicate any outstanding investigations and review the results when available.
Complete referral information helps minimise delays in determining the most appropriate diagnostic pathway.
FIT only assesses the risk of bowel cancer and does not exclude other pathology. Patients with persistent, worsening or changing symptoms should continue to receive appropriate clinical review and safety-netting. Alternative referral routes, Advice & Guidance, or further investigation may be appropriate depending on the clinical picture.
Thank you for your continued support in delivering timely and appropriate care for patients with lower GI symptoms.
For further information please contact:
Rebecca O’Connell
Lead Cancer Manager – Cancer Services
Block 14, Barnsley Hospital
Contact Number: 07598 069052 | Email: rebecca.oconnell9@nhs.net
Updated: October 2026
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Clinical support group
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Cancer, Palliative Care, Pain and Older People
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Gastroenterology
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Conditions and indicators
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