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FIT Resource Hub

FIT Kit
FIT collection device

As of June 24, 2019, the fecal immunochemical test (FIT) is the recommended screening test in Ontario for people at average risk. ColonCancerCheck no longer recommends screening with the guaiac fecal occult blood (gFOBT).

Although there is high-quality scientific evidence to support screening with gFOBT, FIT offers several advantages over gFOBT:

  • FIT is a more sensitive screening test, which means it is better at detecting colorectal cancer and pre-cancerous polyps;
  • There are no medication or dietary restrictions (including anticoagulants and vitamin C);
  • FIT is simple to use and helps reduce contact with stool; and
  • Only one stool sample is needed.

This Resource Hub contains tools and resources to support primary care providers, endoscopists and others during the transition to FIT in Ontario. For guidance on the decommissioning of gFOBT, please see the gFOBT decommissioning FAQs in the list of resources below.   

If you have any questions, please contact Cancer Care Ontario toll-fee at 1.866.662.9233 from Monday to Friday 8:30 a.m. to 5:00 p.m. or screenforlife@cancercare.on.ca.

Thank you for supporting a successful transition to FIT in Ontario.

For current colorectal cancer screening guidelines, please visit - Healthcare Provider Resources – Colorectal Screening

DOWNLOAD RESOURCES DESCRIPTION TARGET AUDIENCE
Primary Care Provider mail-out products
  • FIT Resource Hub Postcard: To support this transition, promotional postcards for the FIT Hub have been developed. These postcards contain information on how to access the FIT Hub, and what resources are available.
  • Cover Letter: This cover letter provides an introduction of key messages and information on the transition to FIT. It includes information related to key changes in the CCC program, how to prepare your practice for FIT, and highlights resources that are available.
  • CCC Guide to Average Risk Screening with FIT: This tool has information on screening people at average risk of developing colorectal cancer. It includes an overview of the ColonCancerCheck screening recommendations, steps for screening with FIT for providers and screening participants, and links to important provider resources.
  • FIT Instructions for Patients: These instructions help screening participants complete their FIT at home. Participants will get the instructions along with the FIT kit that is mailed to them. Participants and providers will be able to find the instructions online.
  • FIT Requisition Form: This is the new FIT requisition form. It is the only requisition that primary care providers can use to order a FIT for their patients as a part of the ColonCancerCheck program. This form is different from the Ministry of Health and Long-Term Care laboratory requisition.
    Providers should add the new FIT requisition to their inventory of test request forms. Providers can also add the form to their electronic medical record’s (EMR’s) list of available test request forms or they can ask their EMR vendor about creating the form within their EMR.
    • FIT Requisition Form Instructions: These instructions provide guidance for ordering requestors (i.e., primary care providers, Telehealth Ontario and mobile screening coach staff) on how to complete each section of Cancer Care Ontario’s new FIT requisition form.   
  • Frequently Asked Questions About FIT (abridged version): To support this transition, an abridged version of the PCP FAQs have been developed to provide primary care providers with information regarding FIT and changes to the ColonCancerCheck program.
  • gFOBT Decommissioning FAQs: To support this transition, FAQs have been developed to provide primary care providers with information regarding the decommissioning of gFOBT in Ontario.
  • ColonCancerCheck's Recommendations for Post-Polypectomy Surveillance: This document and supporting tool provides recommendations for surveillance after polypectomy.
  • Registration Form to Accept Unattached Patients: The Primary Care Provider Registration for Patient Attachment form provides information on the patient attachment program. It also allows primary care providers to register to accept new patients from the ColonCancerCheck program into their practice.
    Patients requiring attachment need a referral to colonoscopy services because they are either FIT-positive or they have self-identified as being at increased risk for developing colorectal cancer due to their family history.
  • Primary Care Providers
Fecal Immunochemical Test (FIT) Continuing Professional Development (CPD) module and speaking notes To support the transition to the fecal immunochemical test (FIT) in Ontario, a FIT CPD has been created.

Disclaimer:
The intended users of these materials are Regional Primary Care Leads and Regional Indigenous Cancer Leads employed by Cancer Care Ontario. For other individuals who wish to present, or otherwise use these materials, please contact: primarycareinquiries@cancercare.on.ca.
  • Primary Care Providers

Transition to FIT Frequently Asked Questions for Primary Care Providers and Healthcare Administrators

To support this transition, FAQs, including those related to gFOBT decommissioning have been developed to provide primary care providers and healthcare administrators with information regarding FIT and changes to the ColonCancerCheck program.

  • Primary Care Providers
  • Healthcare Administrators
Link to Cancer Care Ontario-funded hospitals for FIT-positive Colonoscopy and Regional Cancer Program FIT websites

This page lists Regional Cancer Program FIT websites and resources to find hospitals funded by Cancer Care Ontario to perform colonoscopies in patients with an abnormal FIT result.

  • Primary Care Providers
gFOBT unsatisfactory result sample letters The new gFOBT unsatisfactory result letters ask people who complete a gFOBT just prior to the launch of FIT, or during the overlap period and get an ‘invalid’ or ‘rejected’ result, to complete a FIT. The new gFOBT unsatisfactory letters will be sent starting at FIT launch, and will continue for as long as gFOBT results are received by Cancer Care Ontario.
  • Primary Care Providers
FIT Webinar for Primary Care Physicians

To support the transition to fecal immunochemical test (FIT), Cancer Care Ontario hosted an interactive webinar focused on how to order FIT with the FIT requisition, FIT return and reporting, and tools to support primary care physicians and their patients.

This webinar does not replace a continuing professional development (CPD) education session. Please contact your Regional Primary Care Lead or Regional Cancer Program to find out when the next accredited FIT CPD education session is being delivered in your region.

Please note that this webinar recording will only be available until September 30, 2019.

  • Primary Care Providers

Registered Nurse Flexible Sigmoidoscopy (RNFS) Eligibility Tool

This tool summarizes the participant eligibility criteria for Registered Nurse Flexible Sigmoidoscopy (RNFS).

  • Primary Care Providers

First Nations, Inuit and Metis-related Resources (Colon Cancer Screening Fact Sheets).

Cancer 101 video

Cancer and Screening Toolkit

Colon Cancer Screening Factsheets: These “Honouring the First Nations, Inuit and Métis Path of Well-Being” fact sheets have information on colon cancer screening, including:
  • What is cancer screening?
  • What is the ColonCancerCheck program?
  • How to get screened?
  • What is colon cancer?
  • Symptoms and issues
  • The Path to Wellness

Cancer 101 Video: Cancer Care Ontario made this video for First Nations people. The video gives basic cancer information and answers to many common questions about cancer. Other groups that helped make the video are CAREX Canada, the Occupational Cancer Research Centre and the Canadian Cancer Society.

Cancer and Screening Toolkit: The toolkit helps people talk with their healthcare providers about cancer screening. It has information on:

  • Culturally appropriate cancer and screening for First Nations people and healthcare providers caring for First Nations people
  • The colorectal, breast and cervical screening programs in Ontario
  • First Nations, Inuit and Métis communities
  • Health Care Providers
  • Indigenous organizations
FIT Instructions for Patients (other languages)
These instructions help screening participants complete their FIT at home. Participants will get the instructions along with the FIT kit that is mailed to them. Participants and providers will be able to find the instructions online. Available in 32 languages.
  • Primary Care Providers
Choosing Wisely at North York General: Fecal Occult Blood Testing (FOBT) This article describes the successful strategy to prevent inappropriate use of fecal-based testing by restricting the use of FOBT among in-patients at North York General Hospital. 
  • Endoscopists
  • Primary Care Providers
Teachable Moment: Inappropriate Use of Fecal Occult Blood Testing This case study provides a clinical example illustrating the impact of inappropriate fecal occult blood testing in terms of diagnostic delay and patient care.
  • Endoscopists
  • Primary Care Providers
Physician-Linked Correspondence Consent Form Cancer screening letters are a key way to encourage people to get screened. Cancer Care Ontario offers physician-linked correspondence, which includes physicians’ names in their rostered patients’ cancer screening letters. Physician-linked correspondence is available to all patient enrolment model physicians in the province for colorectal cancer screening and will expand to include breast and cervical cancer screening. To enrol, fill out the consent form and submit it by fax, email or mail, as indicated in the form.
  • Primary Care Providers
Link to LifeLabs’ provider FIT landing page This link provides high-level information for providers on FIT and information on how to get setup to receive results from LifeLabs.
  • Endoscopists
  • Primary Care Providers

Public Assets:

The following promotional products have been included to support the launch of FIT. Providers may use these to communicate with the public.

  • Primary Care Providers
Social Media Posts

This document contains a series of social media posts for Twitter, Facebook and LinkedIn about the transition to FIT. Providers may use and share these posts through their own social channels when FIT is launched. Please note that links within the posts will not be updated until launch (June 24).

  • Primary Care Providers
DOWNLOAD RESOURCE DESCRIPTION TARGET AUDIENCE
FIT - Positive Colonoscopy: Facility-Level Guidance The purpose of this guidance document is to support planning for timely, safe, high-quality fecal immunochemical test (FIT)-positive colonoscopies at the region, facility, and endoscopist level.
  • Facilities
  • Endoscopists
  • Regional Cancer Programs
Transition to FIT: Frequency Asked Questions for Endoscopists

Ontario will be transitioning from the guiac fecal occult blood test (gFOBT) to the Fecal Immunochemical Test (FIT) for colorectal cancer screening in 2019. To support this transition, FAQs have been developed to provide endoscopists with information regarding FIT and changes to the ColonCancerCheck program.

The FAQs provided will be updated as more information becomes available closer to the go-live date. Please check back periodically for updated FAQs.

  • Endoscopists
  • GI nurses
Link to Cancer Care Ontario-funded hospitals for FIT-positive Colonoscopy and Regional Cancer Program FIT websites

This page lists Regional Cancer Program FIT websites and resources to find hospitals funded by Cancer Care Ontario to perform colonoscopies in patients with an abnormal FIT result.

  • Endoscopists
ColonCancerCheck’s Recommendations for Post-Polypectomy Surveillance This document and supporting tool provides recommendations for surveillance after polypectomy
  • Endoscopists
  • Primary Care Providers

Choosing Wisely at North York General: Fecal Occult Blood Testing (FOBT)

This article describes the successful strategy to prevent inappropriate use of fecal-based testing by restricting the use of FOBT among in-patients at North York General Hospital. 
  • Endoscopists
  • Primary Care Providers
Teachable Moment: Inappropriate Use of Fecal Occult Blood Testing This case study provides a clinical example illustrating the impact of inappropriate fecal occult blood testing in terms of diagnostic delay and patient care.
  • Endoscopists
  • Primary Care Providers
Canadian Association of Gastroenterology (CAG) Skills Enhancement for Endoscopy (SEE)© Program – Colonoscopy Skills Improvement (CSI) Vignettes Video This video demonstrates several important endoscopy techniques in three vignettes:
  1. room setup and scope handling,
  2. torque assistance steering, and
  3. loop resolution and loop recognition.
  • Endoscopists
Canadian Association of Gastroenterology (CAG) Polyp Detection Module - Evidence-Based Practice to Improve Adenoma Detection Video This video describes evidence-based practices that can be used to modify your colonoscopy performance to improve adenoma detection rates.
  • Endoscopists
GI Endoscopy DSP: Data Elements Tutorial Video This video was designed to support endoscopists with understanding the data elements collected by the GI endoscopy data submission portal (DSP), including education on understanding landmarks for determining cecal intubation. Note that this video does not include the updates for FIT.
  • Endoscopists
Link to LifeLabs’ provider FIT landing page This link provides high-level information for providers on FIT and information on how to get setup to receive results from LifeLabs.
  • Endoscopists
  • Primary Care Providers