Over 250 patients have been recruited into a research study at Croydon University Hospital to examine the effectiveness of a new test to rule out bowel cancer and avoid unnecessary investigations, including colonoscopies. The study is being rolled out to other RM Partners acute trusts in the autumn.
Bowel cancer is the third most common cancer in the UK; if found early there is a better chance that it can be treated successfully. Most currently used tests, called faecal occult blood tests (FOBT), look for small amounts of blood in the faeces invisible to the naked eye. These are imperfect and false negative results can occur, which means that the test misses people who possibly may have cancer.
The newer faecal immunochemical test (FIT) has been shown to be more accurate than FOBT, but its sensitivity varies by gender, age and ethnicity. Previous studies have shown that FIT is more acceptable to use as it only requires one sample, compared to three samples required by FOBT.
We aim to recruit over 5,000 patients across west London to determine if FIT can be used as an effective triage tool in primary care to identify those patients most likely to need a colonoscopy. The findings will also be used to further understand the different test results for the population across west London.
Patients who have been referred by their GP under the 2ww urgent referral pathway and who will be having a colonoscopy will be sent a FIT kit to use at home. A member of the FIT study team will contact them to discuss it in more detail and ask if they would like to participate. Patients who agree will still undergo colonoscopy and any other necessary diagnostics.
Results from the FIT test will be compared to colonoscopy findings to determine its effectiveness in predicting bowel cancer. Preliminary results of the study will be reported in early 2018. If the accuracy of FIT is verified, it will be rolled out as a triage test across primary care sites in west London.
Our study is supported by NICE, and if the test proves successful it will be incorporated into NICE guidance for diagnosing bowel cancer in symptomatic patients who see a GP. This research has been identified as priority by NHS England as part of the Five Year Forward View.
For more information please contact Michelle Chen, research manager, at Michelle.Chen@nhs.net