Evaluation of user experiences, perceptions and attitudes towards faecal immunochemical testing (FIT) for risk-stratified colonoscopy in people with Lynch syndrome

Objective: This study evaluates the experiences, perceptions, and attitudes of people with Lynch syndrome (LS) towards faecal immunochemical testing (FIT) as an adjunct to colonoscopy for colorectal cancer surveillance.

Methods: A mixed-methods design included two cohorts: an emergency clinical service during the COVID-19 pandemic and a longitudinal research initiative. Paper-based surveys assessed user experiences and attitudes using Likert scales and open-ended questions. Quantitative data were analysed for response patterns, while thematic analysis explored qualitative feedback.

Results: Among 85% of participants who rated FIT positively, 90% were confident in using the test correctly. Women reported higher anxiety (7.8%) compared with men (2.0%, p=0.045). Thematic analysis revealed gratitude for FIT's convenience during healthcare disruptions but emphasised concerns about its accuracy.

Conclusions: FIT is widely perceived as an acceptable supplemental tool among surveyed people with LS, who appreciate its potential to reduce intervals between colonoscopies without compromising surveillance quality. Ongoing patient engagement is crucial to addressing concerns about FIT's reliability. Future research should evaluate long-term outcomes and explore diverse population perspectives to guide FIT implementation in LS surveillance.