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New research has shown that a simple and inexpensive test can help identify who is at risk of developing colorectal cancer, aiding early diagnosis and potentially saving lives, according to its authors in the British Journal of Cancer.
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 CanTest Collaborative, in the United Kingdom, the new study examined data from almost 4,000 patients from 50 years or more.
The investigation involved all healthcare providers in the South West of England who took a new approach. For six months, they provided the fecal immunochemical test (FIT), which costs around £ 4 (about € 4.50) and can detect traces of occult blood in stool.
The test was given to anyone with symptoms of low risk of colorectal cancer, that is, the symptoms can be caused by cancer of the intestine, but very often they are also caused by other things, such as stomach pain, leakage unexplained weight or anemia. Before this, there was no easy-to-do test available for people with low-risk symptoms of colorectal cancer.
From June to December 2018, 3,890 patients received the FIT. Of these, 618 tested positive for blood in the stool, 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.
Dr Sarah Bailey of the University of Exeter School of Medicine, who led the study, notes: “Our findings are very exciting: we show that this simple and inexpensive test works exceptionally well in this group of patients with low risk symptoms. , to quickly and accurately inform us who is likely not to have colorectal cancer and who should be referred for research. ”
In his view, “at a time when hospital services are facing a delay as a result of COVID-19 measures, making this decision quickly can ensure that the right people are investigated and treated as quickly as possible, which can help save lifes”.
“We know that FIT has accelerated interest in how FIT can be used in other patients, such as those with symptoms who are at increased risk for colorectal cancer, and we are now calling for FIT to be evaluated for use across the spectrum of care. not only in primary care, and in combination with other clinical markers of cancer, such as the results of blood tests, “he adds.
Colorectal cancer has a high death rate: each year, 1.8 million cases are diagnosed worldwide and causes 900,000 deaths annually. Requests for urgent colorectal cancer research have more than doubled since 2012. This is due in part to awareness among physicians that seemingly low-risk symptoms may present as an emergency later, with lower cancer survival.
Dr Joe Mays of the Peninsula Cancer Alliance, which brings together leaders from different hospital funds to improve cancer diagnosis and care in their area, highlights that “rapid and robust analysis has generated the evidence for clinicians to use the test FIT with confidence. ”
He highlights that “this led to a reduction in expected colonoscopy rates, and helped us build a business case for the continued implementation of this service. Building trust and familiarity with the test helped us manage a crisis in the ability to endoscopy caused by the COVID-19 pandemic. Now we are eager to demonstrate the performance of the test in higher risk populations, “he says.
For her part, Dr Jodie Moffat, Head of Early Diagnosis at Cancer Research UK, explains that “FIT is already being used for people who have no symptoms in the bowel screening program. So it’s fascinating to see how this test it can also be used in patients with low-risk symptoms to identify who needs more research. ”
“As with all tests, the FIT is not perfect and some cases can be missed,” he acknowledges, “so it is important that anyone whose symptoms persist, change, or worsen to contact their GP, even if have recently had a negative test result. ”
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