Simple, cheap test can help save lives from colorectal cancer

New CanTest research demonstrates that a simple, cheap test can help identify who is at risk of developing colorectal cancer, aiding early diagnosis and potentially saving lives.

Led by the University of Exeter, and supported by the Peninsula and the Somerset, Wiltshire, Avon, and Gloucestershire Cancer Alliances and by Cancer Research UK, the new study published today in the British Journal of Cancer examined data from nearly 4,000 patients aged 50 and over. The study, published today in the British Journal of General Practice, involved all healthcare providers in the South West of England taking a new approach. Over six months, they provided the faecal immunochemical test (FIT), which costs round £4 and accurately measures whether blood is present in faeces, and if so, how much. The test was given to anyone with low-risk symptoms of colorectal cancer, such as stomach ache, unexplained weight loss, or anaemia. Prior to this, there was no test available for people with low risk symptoms of colorectal cancer.

From June to December 2018, 3,890 patients received the FIT. Of those, 618 tested positive for blood in their faeces, 43 of whom had received a diagnosis of colorectal cancer within 12 months. In the group that tested negative, only eight were diagnosed with colorectal cancer a year later.

CanTest Research Fellow Dr Sarah Bailey, of the University of Exeter Medical School, who led the study, said:

“Our findings are very exciting – we show that this simple and inexpensive test performs exceptionally well, to quickly and accurately tell us who is clear of colorectal cancer, and who should be referred for investigation. At a time when hospital services face a backlog as a result of COVID-19 measures, making this decision quickly can ensure the right people are treated as quickly as possible, which can help save lives. We are now calling for FIT to be evaluated for use across the entire healthcare spectrum, not just in primary care, and in combination with other clinical markers of cancer such as blood test results”

Colorectal cancer has a high mortality rate – each year, 1.8 million cases are diagnosed worldwide, and the disease causes global 900,000 deaths annually. Requests for urgent colorectal cancer investigations have more than doubled from 2012. This is in part because of awareness among clinicians that seemingly low-risk symptoms can later present as an emergency, with the lowest survival rates.

Dr Joe Mays, of the Peninsula Cancer Alliance, which brings together leaders from different hospital trusts to improve cancer diagnosis and care in their area, said:

“The rapid and robust analysis has generated the evidence for doctors to use the FIT test with confidence. This led to a reduction in the expected rates of colonoscopy, and helped us build a business case for the ongoing commissioning of this service. Building confidence and familiarity with the test helped us to manage a crisis in endoscopy capacity caused by the COVID-19 pandemic. We’re now keen to evidence the performance of the test in higher risk populations.”

The paper is available online at Nature here and received coverage in national media in The Telegraph, Daily Mail and on Yahoo News.

Bailey SER, Abel A, Atkins A, Byford R, Davies S, Mays J et al. Diagnostic performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England. British Journal of Cancer, 2020. In press.


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