New test to improve population-based colorectal cancer screening

The new stool test appears to be better at detecting colorectal cancer precursors than current stool immunochemical tests. This could further reduce the number of new cases of colorectal cancer and deaths from colorectal cancer. A study led by the Netherlands Cancer Institute compared both tests.

their results are published in lancet oncology.

Each year, approximately 1.9 million people are diagnosed with colorectal cancer and 935,000 people die from colorectal cancer worldwide. Colorectal cancer is curable if detected early. However, by then the following symptoms may appear: weight loss Or, even if blood appears in the stool, it is often too late. As a result, many countries have introduced population-based testing programs. For example, the Netherlands recommends that people between the ages of 55 and 75 get tested every two years.

Most population-wide screening programs Fecal immunochemical test (FIT), a stool test that measures the presence of the blood protein hemoglobin. World wide, Colorectal cancer screening These programs have proven successful in diagnosing colorectal cancer early and reducing mortality from colorectal cancer.

three proteins

“Current tests are working well, but there is still room for improvement,” said Gerrit Meyer, lead researcher at the Netherlands Cancer Research Institute. “We want to be able to detect tumors before they become invasive, at the stage of larger precancerous polyps. Then treating physicians can choose to treat colon cancer rather than surgery. We will be able to remove these polyps during the endoscopy.”

Meyer and colleagues at the Netherlands Cancer Institute, Amsterdam UMC, and Erasmus MC have been working on the new test for years. This multi-target FIT test (mtFIT) measures hemoglobin and her two additional proteins.earlier retrospective study showed promising results.

cancer precursor

Today, researchers announced the results of a much larger prospective study comparing mtFIT to current FIT in more than 13,000 participants in a national population-based screening program in the Netherlands. The research was successful.

“The new test can detect cancer precursors more effectively,” Meyer explains. “Our results predict that this test could reduce the number of new colorectal cancer cases and the resulting mortality rate.”For participants, the new test will be as easy to use as the current test. is.

More true positive results

The new test yielded more positive results than the current test. This led to an increase in colonoscopies, but with the new mtFIT test, doctors found abnormalities in 299 of her patients. In contrast, his current FIT test had him at 159. This difference primarily concerned people with high-risk precursors to colon cancer (216 vs. 114). “The new test is now able to detect larger polyps without significantly increasing 'false-positive' results and therefore unnecessary colonoscopies,” Dr. Meyer said. says.

The exact number of colorectal cancers that can be prevented with this new test depends on how current FIT tests are used in each country.

“The Dutch screening program applies a relatively high cut-off value for the FIT test to be considered positive, which means it is unfavorable. Here, the new mtFIT Testing could reduce colorectal cancer cases by 21% and mortality by 18%. Using a lower FIT cutoff value would lower these numbers, but it is likely that colorectal cancer “At least 5% fewer people will develop cancer, and mortality will decrease by at least 4%. In both scenarios, the new test is likely to be cost-effective.”

Implementation of mtFIT into existing FIT-based screening programs is relatively straightforward, as both tests require essentially the same screening steps.

“This is very good news,” Meyer said. New tests cannot yet replace current mass screening tests. “The next important step is to carry out the test on an industrial scale in accordance with the European diagnostic testing guidelines. To this end, we have established CRCbioscreen to ensure that this test will benefit CRC screening participants in the Netherlands and abroad. It made it possible to bring about.”