Increasing sensitivity of FITs could identify young people with bowel cancer

Increasing the sensitivity of a bowel cancer test used by GPs could help identify more cases of bowel cancer in young people with symptoms of the disease and ultimately save lives, new research co-authored by Bowel Cancer UK has found.

The study, published in Colorectal Disease, is the first of its kind to look into the accuracy of the faecal immunochemical test (FIT) in helping to diagnose bowel cancer in younger patients at high risk of significant bowel diseases, including bowel cancer, advanced polyps and inflammatory bowel disease.

FIT is used in bowel cancer screening programmes across the UK, to identify older adults without symptoms who need to be investigated for bowel cancer. However, FIT is being used more frequently by GPs to help understand which people with bowel symptoms may also need urgent investigations.

Mr Nigel D’Souza and colleagues studied the accuracy of FIT in helping to diagnose bowel cancer and other serious bowel diseases in patients under 50 who had bowel symptoms. Their results suggest that the presence of blood in poo, detected by FIT, can tell clinicians which patients need to be investigated urgently. In particular, younger people with symptoms who have more than 150μg of blood per gram of poo, as detected by FIT, are particularly likely to need urgent investigation.

Mr Nigel D'Souza said: “Whilst the number of bowel cancers diagnosed in younger people remains low, the number are increasing year on year. FIT alone is unlikely to solve the problem of diagnosing younger patients earlier, however, it could be used alongside other measures, such as anaemia, to help GPs to identify those who need urgent referral for significant bowel disease.”

Mr Muti Abulafi, consultant surgeon at Croydon University Hospital and chief investigator of the NICE FIT study which produced this research said: “This research goes a long way to highlighting a problem that is often ignored by both young patients and their treating doctors on the assumption that bowel symptoms in the young are due to functional causes and not due to cancer or serious bowel disease. Whilst this is true to a large extent, the difficult problem is how to identify those small but increasing proportion of young patients who are at highest risk of serious bowel disease i.e. finding the needle in the haystack. This research provides such a tool using a simple at home stool test called FIT.”

Dr Lisa Wilde, director of research and external affairs at Bowel Cancer UK, added: “We’re delighted to be part of Mr D’Souza’s research helping to improve the challenging situation that the 2,500 younger patients diagnosed with bowel cancer in the UK can face.

“We know that time and time again, younger people struggle to have their bowel cancer symptoms taken seriously and are often diagnosed after repeated visits to their GP.

“Nobody should be told they don’t have bowel cancer based only on their age, and referrals for further investigation should be made as soon as possible. Bowel cancer is the second biggest cancer killer in the UK, but it’s treatable and curable, especially when diagnosed early.”

Find out more about Bowel Cancer UK’s Never Too Young campaign here.