CAN04 - Lower GI suspected cancer with FIT in the 21 days beforehand
The information contained within this article is from the 2025/26 IIF business rules.
Indicator definition
Indicator ID | Description |
CAN04 | The proportion of patients who have had a lower gastrointestinal urgent suspected cancer referral in the reporting year where at least one urgent suspected cancer referral was accompanied by a faecal immunochemical test result, with the result recorded in the 21 days leading up to the referral. |
In October 2024, CAN02 was superseded by CAN04. This change by NHS England simplified the requirement by counting patients who had a FIT test recorded in the 21 days prior to a fast-track referral rather than counting individual referrals.
What do the business rules mean?
What makes a patient eligible?
Patients are considered for the CAN04 indicator if they have had a fast-track referral for suspected lower gastrointestinal cancer during the contract year.
How to achieve the indicator
To meet the criteria for CAN04, eligible patients must have:
- A FIT test recorded in the 21 days leading up to the referral
What will remove patients from eligibility?
Patients are can be excluded from CAN04 if:
- they have a FIT test not indicated code added during the contract year
- patients chose not to have a FIT test during the contract year
If a patient has a FIT test result recorded, any exclusions that have also been added are ignored.
Hints and tips for achieving this indicator
This indicator can be achieved by ensuring you have robust systems in place within your practice to safety net FIT testing and subsequent referrals. There are a variety of PCIT tools that can support with this.
SNOMED codes used in this indicator
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.
Fast track referral for suspected lower gastrointestinal cancer codes (GICANREF_COD)
SNOMED code | SNOMED code description |
276401000000108 | Fast track referral for suspected colorectal cancer (procedure) |
892201000000106 | Fast track referral for suspected lower gastrointestinal cancer (procedure) |
Faecal immunochemical test codes (FAECIMM_COD)
SNOMED code | SNOMED code description |
1049361000000101 | Quantitative faecal immunochemical test (observable entity) |
Codes for faecal immunochemical test not indicated (FITNI_COD)
SNOMED code | SNOMED code description |
| 126850006 | Neoplasm of anal canal (disorder) |
140536008 | O/E - PR - rectal mass (finding) |
| 163326007 | On examination - per rectum - rectal mass (finding) |
| 197225001 | Anal ulcer unspecified (disorder) |
| 197227009 | Anal and rectal ulcer NOS (disorder) |
| 20928004 | Ulcer of anus (disorder) |
| 248523006 | Rectal mass (finding) |
| 254585003 | Tumor of anal canal (disorder) |
| 641331000000104 | Anal ulcer unspecified (disorder) |
| 641351000000106 | Anal and rectal ulcer NOS (disorder) |
| 91105001 | Stercoral ulcer of anus (disorder) |
Codes indicating the patient has chosen not to receive a faecal immunochemical test (FAECIMMDEC_COD)
SNOMED code | SNOMED code description |
149441000000102 | Provision of faecal immunochemical test kit declined (situation) |