DIY test set to let thousands escape colonoscopy ordeal
ADIY test that can detect the early signs of bowel cancer could save thous a nds o f Bri t o ns from unnecessary and invasive hospital procedures, say doctors.
The kit is being issued by GPs to NHS patients suffering lower abdominal pain and bleeding, after trials found the test was so accurate that it ‘ruled out’ tumours in more than 95 per cent of cases.
At present, anyone with such symptoms will be referred to a specialist for a colonoscopy, a procedure that involves a camera on a thin flexible tube being passed into the bowel to investigate.
Just four per cent of the 260,000 Britons sent f or t he i nternal examination last year actually had bowel cancer, yet the number of colonoscopy referrals is predicted to nearly double in the next 15 years, imposing a huge burden on already stretched hospitals.
It is hoped that the new Quantitative Faecal Immunochemical Test (qFIT) could slash the number of specialist referrals almost in half. Experts are also considering rolling out the new test as part of the National Bowel Cancer Screening Programme.
Dr Ed Seward, consultant gastroenterologist at London’s UCLH trust, which is running the trial, added: ‘ Too many patients are currently coming into hospital to have what turns out to be an unnecessary colonoscopy.
‘We believe that many of them could take this simple stool test in the comfort of their own home, and get reassurance from their GP without needing to come to hospital for a camera test.’
In England, Wales and Northern Ireland, everyone over the age of 60, regardless of whether they have symptoms, is invited to take part in screening every two years until the age of 75. In Scotland, screening starts at 50.
The programme currently uses another home test called a faecal occult blood test (FOBT), which looks for hidden blood in the stool.
GP surgeries send out these kits to all those eligible in their area.
Three separate samples taken on consecutive days are needed to complete the FOBT, which experts claim is a major reason just 50 per cent of those eligible take the test.
The qFIT test involves only a single sample, and studies suggest that people are far more likely to do it.
Another problem with FOBT is that it has a 50 per cent false negative rate, meaning it does not pick up signs of the disease in half of cases. Experts say qFit is much more precise.
After lung and prostate cancers, bowel cancer is the third most common cancer in men and, after breast cancer, the second most common cancer in women.
Rocker Ozzy Osbourne’s wife Sharon was diagnosed with it in 2002. She had treatment and it has not returned.
Approximately 42 per cent of bowel cancer picked up during screening – before symptoms begin – is in the earliest stage, with a 95 per cent cure rate.
Conversely, 92 per cent of patients who are symptomatic by the time they are diagnosed are in the later stages, meaning that survival is less likely.
Bowel cancer is the second most common cause of cancer death in the UK, with about 16,000 people dying each year, 90 per cent of them over 50.
The first phase of the qFIT pilot is being rolled out to patients in NorthCentral and North-East London, and west Essex, through more than 30 GP practices and six NHS trusts. Patients who have been urgently referred for a lower abdominal examination, due to suspected cancer, will be asked to take the new test at home as an addition to their assessment.
THE results of both the qFIT test and the colonoscopy will then be compared t o c heck that the qFIT test has successfully predicted the result of their colonoscopy.
The pilot aims to gather results from a minimum of 2,000 patients in London over six months. Consultant colorectal surgeon Michael Machesney, of Barts Health NHS Trust, explained: ‘In the old FOBT test, a lab technician will spray the stool sample with a chemical that causes a colour change in any blood present, so they can visually analyse it.
‘The qFIT test is done by machine, and gives an exact amount of haemoglobin, a protein in blood, present. The current trials will help us determine the exact threshold level that will help us diagnose bowel cancer, or rule it out.’