Faecal tests to identify those at risk could boost screening

Faecal testing can distinguish those at high and low risk of colorectal cancer and could be used to encourage high-risk individuals to attend repeat testing.

Colorectal cancer risk scores could be used to educate patients (Photograph: SPL)
Colorectal cancer risk scores could be used to educate patients (Photograph: SPL)

A team from Taipei Medical University in Taiwan carried out a prospective analysis of an immunochemical faecal occult blood test screening programme for individuals aged 40 to 69 years old.

During the study, 44,324 individuals had negative test results and 1,688 had positive results.

The researchers studied the relationship between baseline faecal haemoglobin concentrations and risk of incident colorectal neoplasia.

Compared with individuals with faecal haemoglobin concentrations of 1-19ng/ml, those with higher (20-39ng/ml) concentrations had a 43 per cent higher risk of incident colorectal neoplasia.

Those with the highest concentrations (80-99ng/ml) were more than three times as likely to develop colorectal neoplasia.

These findings held when the researchers controlled for repeated tests and for age, sex and family history.

They concluded: 'Our study suggests that baseline faecal haemoglobin concentrations below the normal limit at which a patient is referred for colonoscopy can be informative when planning subsequent triage.'

The researchers pointed out that uptake has been problematic in several bowel cancer screening programmes.

'Using baseline faecal haemoglobin concentration as a predictor of incident colorectal neoplasia provides a basis for participants to be educated about their risk, and might encourage uptake at subsequent screenings,' they said.

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