Doubling up bowel cancer detection: The power of two tests

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Introduction to the Study

A groundbreaking study, recently published in the British Journal of Surgery, discovered that the accuracy of bowel cancer detection nearly reaches 100% when using a standard test twice instead of just once.

The test in question, known as the fecal immunochemical test (FIT), helps detect blood in bowel movements that aren’t visible to the naked eye. This hidden blood could indicate the presence of bowel cancer.

The Importance of Early Detection

Bowel cancer, a significant health concern in the U.K., is the country’s fourth most common cancer and the second largest cause of cancer-related deaths. Every year, over 16,500 people die due to this disease.

Detecting bowel cancer early can significantly improve treatment outcomes. It’s a curable disease when caught in the initial stages.

However, the symptoms of bowel cancer aren’t specific and often resemble those of less serious bowel diseases. This overlap can lead to unnecessary invasive investigations.

Currently, a single FIT test is performed to decide if a patient should be referred to a specialist.

Upon referral, the test results are used to decide if further examination is necessary based on the patient’s apparent risk of bowel cancer.

A Two-Test Approach

Scientists from the University of Edinburgh decided to examine the potential benefits of conducting the FIT test twice.

They used two groups of patients from NHS Lothian, who had been urgently referred to the Edinburgh Colorectal Surgery Unit, to compare the effectiveness of one FIT test versus two.

The results were impressive. The double-FIT test approach correctly identified 96.6% of bowel cancer cases, whereas using only one test picked up 84.1%. The average time between the two tests was 13 days.

Moreover, the study showed that approximately 16.8% of patients who underwent two FIT tests had sufficient variation in their results to warrant a change in their treatment plan, regardless of the presence of significant bowel conditions.

This data underscores the advantages of repeated testing.

Patient Safety and Health System Impact

An important implication of the double-FIT test strategy is its potential to reduce the need for invasive procedures in patients with low bowel cancer risk.

The study demonstrated that patients with two negative FIT tests have a very low underlying risk of bowel cancer (0.17%) and may not need further tests that might cause harm.

While this strategy might slightly increase the number of positive test results (by 7.3%), researchers believe this doesn’t pose a significant burden on the health system.

Instead, it opens up the possibility for alternative management plans for patients with two negative tests.

Impact on Patient Care

Farhat Din, one of the researchers, remarked, “Our study highlights how to maximize the use of FIT in symptomatic patients. Using two FIT tests will miss less bowel cancer, positively impacting patient care.

Locally, implementing the double-FIT strategy has led to a reduction in endoscopy procedures without adversely affecting cancer detection rates.”

This study holds the potential to influence clinical practice, prioritizing patient safety, and efficiency of the health system.

As the use of FIT tests as the primary tool for suspected bowel cancer increases across the U.K., this approach offers a promising way to optimize their use and improve patient outcomes.

If you care about cancer, please read studies that a low-carb diet could increase overall cancer risk, and can vitamin D help prevent or treat cancer?

For more information about health, please see recent studies about how drinking milk affects the risks of heart disease and cancer and results showing dairy foods may increase men’s risk of prostate cancer.

The study was published in the British Journal of Surgery.

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