The effect of the CRC-screening success is that the need for colonoscopy
now exceeds the Danish capacity, in total.
Since, approx. 50-70% of all colonoscopies are without any findings, methods─
which can lead to a more precise identification of those
who are in really need of a colonoscopy─are sought after.
25% of the colonoscopies derived from the general CRC-screening
(based on occult blood in stool samples (the FIT-test))
could be saved—and the individual avoid unnecessary colonoscopy—
provided, the combination of ahe person’s age, the current FIT-test for CRC-screening
plus the result of a blood-based biomarker test.
TRIAGE in the CRC-screening—i.e.:
(1) the person’s age + (2) a FIT-test (level of occult blood in a stool sample)+
(3) a blood-based biomarker test = recommendations of colonoscopy or not.
to subjects with symptoms attributable to colorectal cancer:
International results show that the screening FIT-test
is,also, suitable for selection to diagnostic colonoscopy
among subjects referred to colonoscopy due to symptoms of coloncancer (CRC).
Besides, our research in blood-based cancer biomarkers shows
that a blood-test for cancer-associated biomarkers can be crucial for
identification of subjects with CRC or precursors of the disease.
Thus possibly, a FIT-test and a blood test combined with the person’s age (TRIAGE)
could be used for identifying subjects in really need of a colonoscopy
among all those referred to diagnostic colonoscopy
in the many, currently, offered cancer examination processes.
Consequently, we have designed a research project
to validate the use of the triage concept for selection to colonoscopy
among subjects with symptoms attributable to colorectal cancer.
The project was initiated as a pilot Oct. 2018.
Over a 2-year period (2019-2020) we are to include 2,500 persons referred for diagnostic colonoscopy
—due to symptoms of bowel cancer— at five cooperating hospitals.
A significant reduction of the total number of colonoscopies for the benefit of the health economics;
but, not in the least, for the individual,
who could avoid an unnecessary, unpleasant and not risk-free examination.
The publication on the basic research results:
“Serological biomarkers in triage of FIT-positive subjects?”
(moreover cf. the media coverage:
Videnskab.dk (16.11.20) —DR / P1 Morning (16.11.20) — Jyllands-Posten (16.12.01) — BT (16.12.01)