FIT to Find Cancer

New type of blood test helps detect colon cancer sooner

(RxWiki News) According to a new study published in the journal Gastroenterology, testing between colonoscopies helps detect colorectal cancer (CRC) and advanced tumors that go unnoticed or develop rapidly.

According to Graeme P. Young, MD, AGAF, FRACP, of Flinders Medical Centre, Australia, and lead author of the study, fecal immunochemical testing (FIT) - a new type of stool blood test - can help doctors detect cancer much sooner than if they were to wait for the normally scheduled colonoscopies. This finding is especially helpful for patients with a family or past history of CRC, as they are at a higher risk of developing new tumors. "In those patients who consistently returned a negative fecal immunochemical test," says Dr. Young, "the chance of finding cancer or advanced adenoma was significantly reduced."

A guideline set forth by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology recommends that average-risk adults, starting at age 50, should receive a colonoscopy every ten years. In between that ten-year span, a yearly FIT can help detect cancerous growths sooner. The guideline urges that any positive FIT should be followed up by a colonoscopy.

This study surveilled a group of 1,736 patients with a family or personal history of CRC for a total of 8,863 person years. In order to be included in the study, patients must have received an initial colonoscopy with at least one follow-up. These colonoscopies had to be performed with the presence of a training-accredited colonoscopist.

The results show that FITs detected 12 of 14 cancers and 60 of 96 advanced adenomas in the 1,071 asymptomatic subjects who returned at least one FIT after colonoscopies. In those cases that FIT was positive, subjects were diagnosed with cancer 25 months sooner and with advanced adenomas 24 months sooner.

Patients with a family or personal history of CRC have a higher risk of developing CRC than others. Consequently, they are recommended to have colonoscopic surveillance more frequently and at regular intervals. Patients with only one or two small adenomas with low-grade dysplasia are recommended to have their second surveillance colonoscopy after an interval of 10 years. However, these individuals run a greater risk if there is a delay in detecting lesions.

"Our study results suggest," says Dr. Young, "that interval fecal immunochemical testing in a high-risk colonoscopy program can be used for detecting missed or rapidly developing lesions."

Because of its enhanced sensitivity to cancer and adenomas, FIT is being increasingly used.

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Review Date: 
December 7, 2010