Benefits of at-home bowel cancer tests

At-home bowel cancer screening tests may help to reduce the frequency of colonoscopies for some above-average-risk individuals according to Flinders University.

A new Flinders University study published in Clinical Gastroenterology and Hepatology in which the research team conducted a retrospective analysis of more than 3300 people enrolled in the Southern Cooperative Program for the Prevent of Colorectal Cancer (SCOOP) – an SA-based bowel cancer program – has found that there is a low risk of advanced tumours following multiple negative tests, adding weight to the benefits of at-home faecal immunochemical tests.

“Due to the risks, costs and burden on the health care system from surveillance colonoscopies for bowel cancer, there is a need to explore how we can further personalise screening intervals,” says study lead author Dr Molla Wassie, an NHMRC Emerging Leadership Fellow in the Flinders Health and Medical Research Institute.

“While people at a high risk are encouraged to undertake surveillance colonoscopies every 1 to 5 years depending on their family history and prior colonoscopy results, faecal immunochemical tests could be one way of identifying those who could extend their surveillance interval out further.”

In the study, participants had no bowel cancer found at their previous colonoscopy and had been recommended to have another in 3 to 5 years, while also being sent a faecal immunochemical test annually.

“We found the risk of the follow-up colonoscopy identifying advanced neoplastic lesions including cancer following a negative FIT was around 1 in 10, with this risk decreasing further with every subsequent negative result, with the risk only 5.7% after four negative tests,” says Dr Wassie.

The authors say this supports the use of faecal immunochemical tests to further personalise an individual’s cancer surveillance interval and reduce the overall frequency of colonoscopies.

“Like any surgery, a colonoscopy can be invasive and carries risks for the patient. Add this to access issues, costs and the burden it places on our already strained healthcare system and there is a significant need to ensure current recommendations are suitable,” says Dr Wassie.

“In colonoscopy surveillance programs in Australia, intervals up to 10 years between colonoscopies have recently been suggested as a suitable timeframe for cancer surveillance after low-risk findings.

“Our study supports the introduction of annual at-home faecal immunochemical tests to be incorporated into surveillance programs, but like any surveillance program, uptake and adherence to the surveillance schedule will be a key factor in its success.”

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