Low-cost test could help GPs diagnose cancer at an early stage, study shows

GPs could help to speed up diagnosis of patients with colorectal cancer and other serious bowel diseases through the use of a safe, low-cost test, research has shown.

(Photo: iStock.com/sturti)
(Photo: iStock.com/sturti)

The faecal immunochemical test (FIT) - which works by detecting microscopic levels of blood in faeces - could be effectively used as a 'rule-in' test to detect colorectal cancer and other serious bowel diseases in patients with non-alarming symptoms, researchers said.

A year-long study conducted in Denmark found that the use of a FIT helped GPs to diagnose the majority (67%) of colorectal cancer cases in early stages one and two, increasing patients’ chance of a full recovery.

The research, which was published in the British Journal of Cancer, is the first study to investigate the use of a low-cost FIT in patients presenting with non-alrm symptoms of colorectal cancer.

The researchers said that the majority of new colorectal cancer cases were found on symptomatic presentation in general practice and  around 50% of these patients present with symptoms and signs that do not qualify for urgent referral.

'For these patients, the GP will often use a "wait and see" and safety netting approach, which is reflected in a longer diagnostic process compared to patients with alarm symptoms. This may lead to stage progression and ultimately to poorer prognosis. New diagnostic strategies could contribute to [and] aid the GP in the diagnostic work-up of patients with non-alarm symptoms of colorectal cancer,' the researchers added.

Study results

For the study a total of 3,462 valid FITs were performed on patients aged 30 years and under who presented with non-alarm symptoms of colorectal cancer between 1 September 2015 and 30 August 2016. Of these, 540 (16%) were positive, resulting in urgent colonoscopy referrals. Three months after the initial FIT was performed as a rule-in, 9.4% (51) of patients were diagnosed with colorectal cancer - 67% of whom were in the early stages one or two of the cancer and 20% of whom were in the later stage four.

In addition, 13.5% (73) of those who received a positive FIT were diagnosed with some other serious bowel disease, and were treated accordingly.

The false negative rate for colorectal cancer was <0.1% for the initial three months after the FITS were first performed.

The researchers said awareness of false negative test results was important when using the test and further studies were needed to assess the exact performance of the FIT.

However they concluded: ‘Our results suggest that the FIT may be used as a rule-in test in this group of patients to detect both colorectal cancer and serious bowel disease in primary care, and that the stage distribution of detected colorectal cancer by this method may be more favourable.

‘We consider the findings of importance in a realistic diagnostic work-up of patients with non-alarm symptoms of colorectal cancer and it reveals a possible diagnostic supplement for a group of patients that are notoriously difficult to handle in primary care.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Subject access requests to GP practices increased by a third under GDPR

Subject access requests to GP practices increased by a third under GDPR

The number of subject access requests (SARs) GP practices receive each month has...

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

A promotional video for Babylon GP at Hand that shows a patient with a sore throat...

Review into overprescribing aims to give GPs power to challenge hospital scrips

Review into overprescribing aims to give GPs power to challenge hospital scrips

A government review of overprescribing in the NHS could see GPs given more power...

Submit your session ideas for the RCGP Annual Conference 2019

Submit your session ideas for the RCGP Annual Conference 2019

GPs can now submit ideas for sessions at the RCGP Annual Conference in Liverpool,...

Scottish GP workforce increases for first time in 10 years, figures show

Scottish GP workforce increases for first time in 10 years, figures show

GP numbers in Scotland have risen slightly for the first time in 10 years despite...

More than 16m GP practice appointments a year lost to DNAs

More than 16m GP practice appointments a year lost to DNAs

More than 16m appointments at GP practices are lost every year because patients fail...