Each year worldwide, approximately 1.9 million people are diagnosed with colorectal cancer, and 935,000 people lose their lives as a result of the condition. If detected early, colorectal cancer is often curable. However, by the time symptoms such as weight loss or blood in the stool appear, it may be too late.
That is why many countries have introduced population-based screening programs. In the Netherlands, for example, people between the ages of 55 and 75 are invited to be tested every two years. Worldwide, colorectal cancer screening programs have proven to be successful in diagnosing colorectal cancer at earlier stages and reducing colorectal cancer mortality.
Three proteins
Most population-wide screening programs use the fecal immunochemical test (FIT), a stool test that measures the presence of the blood protein hemoglobin.
"The current test performs well, but leaves room for improvement," says Gerrit Meijer, Head of Research & Innovation at the Department of Pathology at the Netherlands Cancer Institute. "We want to be able to detect the tumors before they have become invasive, that is at the stage of larger premalignant polyps. Treating physicians then can remove these polyps during a colonoscopy, rather than by surgery." Prof. Meijer and his colleagues at the Netherlands Cancer Institute, Cancer Center Amsterdam, and Erasmus MC have been working on a new test for years. This multitargetFIT-test (mtFIT) measures hemoglobin and two additional proteins. An earlier retrospective study demonstrated promising results.
Cancer precursors
Today, the researchers published the results of a much larger, prospective study that compared the mtFIT to the current FIT in over 13,000 participants of the Dutch national population-based screening program. The study was a success. "The new test can detect cancer precursors more effectively," Prof. Meijer explains. "Our results predict that the test can reduce the number of new cases of colorectal cancer and mortality resulting from it." For participants, the new test is just as easy to use as the current test.
More true-positive results
The new test yielded more positive results than the current test. While this led to more colonoscopies, with the new mtFIT test doctors found abnormalities in 299 persons, compared to 159 persons with the current FIT test.
Screening program
"This is exceptionally good news," says Prof. Meijer. The new test cannot replace the current population screening test just yet, but implementation of mtFIT in existing FIT-based screening programs should be relatively easy because both tests basically require the same screening logistics. "The critical next step is to produce the test at an industrial scale according to European diagnostic test guidelines. To this end we founded the company, to enable the test to benefit CRC screening participants in the Netherlands and beyond."
Funding
This study was financially supported by KWF Dutch Cancer Society, Health Holland, Maag Lever Darm Stichting, Stand Up To Cancer’s (SU2C) and CRCbioscreen (supported by The Mark Foundation for Cancer Research and Human+)
Cancer Center Amsterdam Researchers Involved
Francine van Wifferen
Marjolein J E Greuter
Evelien Dekker
Veerle M H Coupé
Article is slightly adapted from the original on the NKI website, with permission.