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Headline

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

Comment

'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.

Posted date

01 Oct 2017

Posted time

11:32pm

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