Patient experience and satisfaction with symptomatic faecal immunochemical testing: an explanatory sequential mixed-methods evaluation

Background Recent evidence suggests that faecal immunochemical testing (FIT) can rule out colorectal cancer (CRC) in symptomatic adults. To date, there has been little research exploring experiences of FIT for this population. Aim To explore patient experience and satisfaction with FIT in an 'early adopter' site in England. Design Explanatory sequential mixed-methods approach combining mailed quantitative surveys with semi-structured telephone interviews. Method Multivariate logistic regression was used to analyse quantitative data. Thematic analysis was used to assess qualitative transcripts. Results The survey had 260 responders, and it found that satisfaction with FIT was high (88.7%). Compared with test satisfaction, the proportion of responders satisfied with their GP consultation and how they received their results was lower (74.4% and 76.2%, respectively). Multivariate analysis showed that increased area-level deprivation and not receiving an explanation of the purpose of the test were associated with lower satisfaction with the GP consultation (both P-values <0.05), while increased area-level deprivation and not receiving results from the GP were associated with lower satisfaction with receiving results (both P-values <0.05). Interviews with responders (n = 20) helped explain the quantitative results. They revealed that 'not knowing the purpose of the test' caused 'anxiety' and 'confusion', which led to dissatisfaction. 'Not receiving results from GP' was considered 'unacceptable', asthis left patients with a 'niggling doubt' and lack of diagnosis or assurance that they did not have cancer. Conclusion Patient satisfaction with symptomatic FIT is high. Efforts to improve satisfaction should focus on ensuring that patients understand the purpose of the test and always receive their test results.