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GPs buried under trusts' workload dump

Home-testing for bowel cancer could 'halve' colonoscopy investigations, says NHS England

NHS England is expecting that a new home-testing kit for bowel cancer will cut the number of 'invasive' colonoscopy investigations by half.

According to NHS England, the 'FIT' test can predict bowel cancer by precisely recording the presence of any blood in just one gram of faeces.

Over the next year, NHS England is funding a £550,000 research project covering 6,000 patients across nine trusts in West London.

It will see researchers examining how levels of blood may vary by age, sex and ethnicity, in a bid to ensure the test gives accurate results regardless of who is using it.

If deemed successful, this could save NHS millions every year, as the self-testing kit costs just £5 compared with £372 for each colonoscopy.

The research, which will be led by Croydon Health Service NHS Trust, will be England's largest-ever study into the accuracy of FIT and follows a call for evidence from NICE.

It follows on from a previous, smaller study by the same team which concluded that the FIT test could reduce investigations by at least 40%.

GPs referred 302,643 patients for urgent investigation in over the past year, a rise of 15% annually, but 95% were found not to have bowel cancer.

NHS England's national cancer director Cally Palmer 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.'

It comes as new research, published last week, found that an algorithm used to detect bowel cancer risk based on blood test results could improve the accuracy of colorectal cancer screening.

Readers' comments (4)

  • AlanAlmond

    '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.'

    It's fascinating to note the researchers hope this will enable faster and earlier diagnosis of cancer ...and yet the primary motivation seems to be reducing the number of colonoscopies performed, to save money. I'm sorry but a faecal blood test isnt an alternative to a colonoscopy. It might help identify people who need further investigation but I think it's very shaky ground to suggest absence of blood in a faecal sample is a reason NOT to proceed to colonoscopy in someone who's history suggests they need a colonoscopy. So what if 95% of those refered don't have cancer ..that means 5% do. What proportion of people randomly pulled off the street and sent for colonoscopy have cancer I wonder ....0.1%? If 100% of people referred by GPs had cancer do you think that would mean GPs were doing a better job...or just excluding hundreds of cases that weren't barn door bleeding obvious? A 5% hit rate isn't actually that bad. Will excluding people from colonoscopy because they don't have blood in their poo increase the hit rate for colonoscopy ...probably. Will it increase the number of poor folk who do have cancer but are missed ..almost for sure. But I guess that'll be the GPs fault hey..not the colonoscopy people. They can't be blamed for not diagnosising cancer in someone they never got refered can they? But a GP certainly will be asked to carry the can for the weird non standard individual who's stool didn't have blood but they did have cancer. Even if that's 1 in a 1000 (entirely arbitrary figure) ...that'd be often enough to happen almost for certain to every GP over the course of a career. No wonder GP indemnity keeps rising. The agenda is always to save secondary care some money and the risk and cost is always moves in the direction of primary care.

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  • NICE advises referral if guidelines indicate a patient crosses the threshold of a Positive Predictive Value of 3% now, from the previous 5%, so doesn't that mean that...?
    No, sorry I must be seeing this too simplistically. Silly me.

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  • DIY DIY, soon we will be asked to scope ourselves. Let us see if the patient sues or if one gets struck off if you do not refer.

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  • This works as a screening test for the assymptomatic, but surely not as a reason not to assess further those patients with symptoms

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