Advanced screening test to improve European colorectal cancer survival rates

Colorectal cancer is the most common type of GI cancer in Europe, with 342,137 new cases recorded in the EU in 2012. It accounts for about half of all gastrointestinal malignancies in Europe and the annual incidence is predicted to rise by 12% by 2020.

As early detection results in a 90-95% survival rate, United European Gastroenterology (UEG), is urging all European men and women over 50 to ‘Step Up, Take the Test’ and undertake screening for colorectal cancer. In support of Colorectal Cancer Awareness Month (March), UEG also calls upon all EU countries to evaluate advanced screening techniques, such as a simple faecal immunological test, to help increase uptake and survival rates.

Faecal immunochemical testing (FIT) is more advanced than the traditional three sample stool test, guaiac-based faecal occult blood tests (gFOBTs). It requires just a single stool sample to check for the presence of blood, a possible indicator of adenomas or CRC and with an easy collection device, it has been found to increase participation uptake.

More importantly, FIT offers substantial clinical benefits due to its superior analytical technique. The gFOBT method relies on simple oxidation which can be adversely affected by the influence of dietary haemoglobin. However, the FIT technique is more sensitive. Specific analysis for haemoglobin detects smaller levels of bleeding and therefore more early cancers as well as more adenomas. The number of false positives is also reduced as there is unlikely to be significant interference from dietary haemoglobin found in faeces. If an adverse result is detected, patients are then referred for a colonoscopy.

FIT’s simple collection system and enhanced sensitivity offers an attractive alternative to existing gFOBT stool tests as a first-line screening procedure. It will also make it easier for Europeans at risk to get screened and ensure colorectal cancer gets detected as early as possible, enabling thousands to receive successful treatment,” explains UEG CRC screening expert Dr. Monique van Leerdam, from the Netherlands Cancer Institute.

Colorectal cancer is treatable when detected early, yet it is estimated to claim the lives of over 500 Europeans every day. According to the recent Survey of Digestive Health across Europe, although CRC screening programmes are now well established in most European countries, many programmes are still not population based and participation rates vary widely.

Rates for colorectal cancer screening programmes vary from as little as 15% in areas of Poland and just 22% in Belgium to a healthier rate of 64% in Norway and 70% in Finland.  However, uptake generally throughout Europe remains alarmingly low, with the percentage of eligible adults screened in many countries falling way short of the 65% rate considered desirable by the European Commission and already achieved in the USA.

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