New cancer test cuts deaths by 40 per cent

Illustration showing the location of the large and small bowel

A breakthrough in the detection and treatment of bowel cancer has been signalled with the development of a new screening test which can cut deaths from the disease by up to 40 per cent.

The one-off five-minute test, conducted at age 55, could save 3,000 lives a year, the researchers said.It could prevent a further 5,000 people from developing bowel cancer, which is Britain’s second biggest cancer killer, according to the study. The researchers called on whichever party forms the new Government to introduce the test as a ‘matter of urgency’ after the election.

Experts said the trial results were ‘one of the most important developments in cancer research for years’. The test involves examining the lower part of the bowel with a small flexible scope and removing any small growths called polyps, which can become cancerous if left untreated.

Experts believe that most of the growths that will ever cause a problem are already present in people in their 50s and so if they are removed then, the chances of them developing bowel cancer might be reduced by as much as 80 per cent.

Bowel cancer is the second biggest cancer killer after lung and half of people who develop it will die from it. The research, published in the Lancet, was conducted on 170,000 healthy people by a team at Imperial College London and were followed up for an average of 11 years. The results were so impressive that Harpal Kumar, chief executive of Cancer Research UK has called on whichever party forms the next Government to prioritise a national screening programme using the test.

He said by preventing thousands of cancers it will save the NHS money. “This is one of those rare occasions to use the word breakthrough. It is extremely rare to see clinical trial results as compelling as these. It is a no-brainer, this has to be introduced. “Every party is going to have to look at the results of this trial and ask themselves ‘can we afford not to do this?'”

The study found that 191 people needed to be screened with the test to prevent one cancer cancer and 400 needed to be screened to save one life. This was in comparison to one in 500 breast cancer screening tests needed to save one life, Mr Kumar said. These figures are expected to be improve even further as the trial subjects are followed-up for longer.

Lead author Prof Wendy Atkin, of Imperial College London, said: “Our study shows for the first time that we could dramatically reduce the incidence of bowel cancer and the number of people dying from the disease by using this one-off test.

“No other bowel cancer screening technique has ever been shown to prevent the disease. Our results suggest that screening with Flexi-scope cope save thousands of lives.” The test, which would be conducted in hospitals to begin with but could be moved into health centres later, takes five minutes to complete, does not cause discomfort and does not require sedation. If polyps are seen they can be removed there and then through the same scope by burning them lightly or cutting them off which only takes a further five minutes and is painless.

If many polyps are found or if they are large the patient can be referred on for a more invasive colonoscopy as this can be a sign of cancer higher up in the bowel.
The test also has the potential to find cancers that have already developed and small ones can be removed in the same way at the polyps. On average in the trial, these were found four years earlier than they would have normally been discovered. More than nine in ten cancers caught at this stage are treatable.

In the trial participants found the test acceptable and in general felt reassured about their future health and were happier afterwards.

A national screening programme could be introduced at age 55 and lead into the existing programme where people aged between 60 and 69 are offered stool testing which can detect cancers throughout the bowel, rather than in the lower sections.

It is thought once a decision is made to introduce the test it could three years for a national programme to be running.

It is not known how much an individual test would cost or how much would be needed for a national programme, however studies have shown that by preventing cancers occurring in the first place, rather than simply detecting them early, the NHS will save money by avoiding expensive treatments.

A spokesman for the NHS Cancer Screening Programmes said: “The study published online today in the Lancet on flexible sigmoidoscopy is very encouraging. The NHS Bowel Cancer Screening Programme always keeps a close watch on any emerging findings or new technologies. This is the first study to demonstrate a reduction in both incidence of and mortality from bowel cancer.”

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