Home-testing kits that detect bowel cancer could almost halve invasive examinations by 2020
A major NHS England funded study is expected to almost halve the number of invasive procedures by 2020 by improving the accuracy of home-testing kits that detect bowel cancer from invisible amounts of blood.
This could mean more than 100,000 NHS patients in England avoid the need for uncomfortable colonoscopies each year by first getting a reliable ‘all clear’ from a simple at-home test.
It could also save the NHS millions, as each colonoscopy costs the NHS £372 compared to about £5 for the new tests.
FIT, the new bowel cancer test, predicts bowel cancer by precisely recording the presence of any blood in just one gram of poo.
The new study will identify how these levels of blood may vary by age, sex and ethnicity – enabling FIT to give very accurate ‘no bowel cancer’ results, regardless of who is using it.
The research will be led by Croydon Health Service NHS Trust (CHS) and is England’s largest study into the accuracy of FIT, both in terms of public participants and the number of sites involved.
Cally Palmer, National Cancer Director at NHS England, said: “We are pleased to support this fantastic study that seeks to revolutionise diagnosis for patients with colorectal symptoms.
“This study, and others like it, is a key component of our transformation plans to improve survival by diagnosing cancer earlier and faster. We will be studying the results closely to see how we can best roll this test out nationally.”
Mr Muti Abulafi, a Consultant Surgeon at CHS and Chief Investigator of the study, said: “We are so thankful to NHS England, NICE and RM Partners for the opportunity to turn a very good cancer test into a fantastic one. We strongly urge people to take part in this research study, which could benefit millions of future patients with bowel symptoms.”
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, said: “This important study will help to increase understanding of how FIT can be used to better identify people in need of a colonoscopy. It is also predicted to help to reduce demand on the overstretched endoscopy service across England, which is vital. We hope that using FIT in this way will also help to speed up the diagnostic process for those at greatest risk of developing bowel cancer. Therefore leading to more people being diagnosed early when the disease is most treatable and curable. We will follow the trial with great interest.”
Matthew Wright, host of the television show The Wright Stuff, tragically lost his father and grandfather to the disease and has given his support to the study. He said: “FIT is simpler and more accurate than any home test we’ve had before. This should mean more people will use it and FIT should help save thousands of extra lives.”
Over the past year in England, GPs referred 302,643 patients to have urgent investigations for suspected bowel cancer (an annual increase of 15 per cent)(1). Most of them underwent colonoscopies and more than 95 per cent of them were found not to have bowel cancer after all.
The study of 6,000 patients is funded by a £550,000 investment from NHS England and will last one year. It involves nine other NHS acute trusts in West London (including North West and South West). The findings will add to the work that is currently being undertaken by other centres.
The same CHS research team conducted a smaller study in 2016(2). It estimated that accurate FIT tests would achieve at least a 40 per cent reduction in ‘unnecessary’ colonoscopies across the West London area (including North West and South West). It is hoped that NICE FIT will find that a similar success rate is achievable throughout the NHS.
It is called NICE FIT because this study of FIT answers a call for evidence from the National Institute for Health & Care Excellence (NICE).
In addition to national support from NHS England and NICE, it is the only national study of FIT to be included in the National Institute for Health Research’s (NIHR) Clinical Research Network Portfolio. This means it meets a high standard of peer review and allows NHS sites across England to participate in the study with NIHR support.
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