Tower Hamlets is set to benefit from the largest pilot study of its kind in the UK to see if a simple stool test that patients can do in their own homes can effectively ‘rule-out’ the presence of colorectal cancer (also known as bowel cancer).
Launched today (12 April 2017) in north central and east London and west Essex, people with abdominal symptoms will be offered the new test alongside existing assessments at hospitals such as The Royal London or by their GP, if registered with a participating GP practice*.
If the pilot study is successful, the test could reduce the number of patients experiencing unnecessary colonoscopies by 40 per cent and transform the way that colorectal cancer is diagnosed.
The Quantitative Faecal Immunochemical Test, known as qFIT, detects hidden quantities of blood in a stool sample that could indicate colorectal cancer. It is much more sensitive than other similar stool tests currently being used. There is growing evidence that the qFIT test could accurately ‘rule-out’ colorectal cancer for patients with suspicious lower abdominal symptoms with over 95 per cent accuracy.
Currently, patients with symptoms such as abdominal pain or blood in their poo are referred by their GP to a hospital for further investigation such as colonoscopy. This involves inserting a small camera through the rectum up into the lower bowel.
Last year, over 260,000 patients in the country with lower abdominal symptoms were seen by a specialist following an urgent GP referral for suspected cancer. The majority of these had a colonoscopy. But only about 4 per cent of these patients actually had cancer. This means that at present, too many people are having unnecessary colonoscopies. Based on predications there will be a 44 per cent increase in current activity over the next 15 years, imposing a huge burden on hospitals.
The new test will be offered to patients in Tower Hamlets at The Royal London Hospital alongside their colonoscopy as further evidence that the test is effective.
Mr Michael Machesney, pilot lead, chair of the London Cancer colorectal pathway board and consultant colorectal surgeon at Barts Health NHS Trust, said:
“The vast majority of colorectal cancers in east London are diagnosed at a late stage which is why local people have amongst the poorest outcomes in the country for colorectal cancer. We want more people to receive an early diagnosis and survive colorectal cancer, the country’s second biggest cancer killer.
“A home testing kit which can effectively rule-out colorectal cancer for patients with lower abdominal symptoms would be a significant step forward in how we care for people and provide them with a much improved experience. If we can successfully prove that the qFIT test can accurately ‘rule-out’ colorectal cancer, we can potentially stem the increasing need for colonoscopy resources and transform the way that colorectal cancer is diagnosed.
“I welcome this exciting study and encourage anyone offered the test to take part and help us to fully understand its effectiveness.”
The first phase of the pilot is being rolled-out to patients in north central and north east London, and west Essex via over 30 GP practices and six NHS trusts. The Royal London Hospital will analyse all tests in its laboratory. Patients that have been urgently referred for a lower abdominal examination, due to suspected cancer, will be asked to take the simple qFIT test at home as an addition to their assessment. The results of both the qFIT test and the colonoscopy will then be compared to check that the qFIT test has successfully predicted the result of their colonoscopy. The pilot aims to gather results from a minimum of 2,000 patients in London over six months.
This is the largest study of its kind, and hopes to replicate the results of two smaller studies in Scotland which found that a normal qFIT result showing no evidence of blood in a stool may rule out the presence of colorectal cancer. Trialling with a diverse population such as east London will evidence the test’s effectiveness and prove its value to everyone.
Dr Ed Seward, consultant gastroenterologist at UCLH, said:
“Whilst colonoscopy is an excellent tool for diagnosing potentially curable bowel cancer, too many patients are currently coming into hospital to have what turns out to be an unnecessary procedure as the pick-up rate for bowel cancer is tiny - only 4%. We believe that many of them could take this simple stool test in the comfort of their own home, and get reassurance from their GP without needing to come to hospital for a camera test.”
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NOTES TO EDITORS
Notes to Editors
*Participating GP practices in Tower Hamlets incudes City Wellbeing Practice, St Stephens Health Centre, St Andrews Health Centre and The Chrisp Street Health Centre.
East London has the highest number of people in the UK being diagnosed with colorectal cancer after going to A&E with symptoms (28 per cent), suggestive of a late diagnosis.
Barts Health NHS Trust
With a turnover of £1.4 billion and a workforce of around 16,000, Barts Health is the largest NHS trust in the country, and one of Britain’s leading healthcare providers. The Trust’s five hospitals – St Bartholomew’s Hospital in the City, including the Barts Heart Centre, The Royal London Hospital in Whitechapel, Newham University Hospital in Plaistow, Whipps Cross University Hospital in Leytonstone and Mile End – deliver high quality compassionate care to the 2.5 million people of East London and beyond.
The UCLH Cancer Collaborative is part of the national Cancer Vanguard. We work with healthcare providers across north central and east London and west Essex to deliver comprehensive cancer care for patients from diagnosis, through treatment, to living with and beyond cancer. The Cancer Vanguard is focused on accelerating the delivery of the key outcomes from the National Cancer Strategy. www.uclh.nhs.uk/cancercollaborative or www.cancervanguard.nhs.uk
UCLH (University College London Hospitals NHS Foundation Trust), situated in the West End of London, is one of the largest NHS trusts in the United Kingdom and provides first-class acute and specialist services. The state-of-the-art University College Hospital which opened in 2005, is the focal point of UCLH alongside four cutting-edge specialist hospitals. UCLH is committed to research and development and forms part of UCL Partners which in March 2009 was officially designated as one of the UK's first academic health science centres by the Department of Health. UCLH works closely with UCL, translating research into treatments for patients. Visit our website www.uclh.nhs.uk, we are also on Facebook (UCLHNHS), Twitter (@UCLH) and Youtube (UCLHvideo).