5-minute colon cancer test could reduce deaths by thousands

Published: Wednesday, April 28, 2010, 11:50 AM

Associated Press health & medical staff

LONDON — A study by British researchers found that the number of deaths from colon cancer could be cut by
about 40 percent with wider use of a five-minute test.
The researchers followed more than 170,000 people for about 11 years. Of those, more than 40,000 had a "flexi-
scope" test, an exam that removes polyps, small growths that could become cancerous.
The test involves having a pen-sized tube inserted into the colon so doctors can identify and remove small
polyps. Researchers used the test on people in their 50s. In the U.K., government-funded colon cancer screening
doesn't start until age 60.
Researchers compared those results to more than 113,000 people who were not screened. They found the flexi-
scope test reduced peoples' chances of getting colon cancer by one third. It also cut their chances of dying by 43
percent. Researchers said the test needed to be done just once in a person's lifetime.
The results were published online Wednesday in the medical journal, Lancet. It was paid for by Britain's Medical
Research Council, National Health Service Research & Development, Cancer Research UK and KeyMed.
Experts said the findings could make some authorities reconsider how they look for colon cancer. Worldwide,
the disease causes 1 million cases and 600,000 deaths every year.

It works by detecting and removing tiny polyps, fleshy growths inside the bowel, which if left untreated can
develop into cancer some years later.
The findings involving 170,432 men and women who were followed for 11 years are published online in The
Lancet journal.
Harpal Kumar, chief executive of Cancer Research UK charity, called for any incoming Government to back Flexi-
Scope screening as a ‘matter of urgency’.
He said: ‘Cancer Research UK does not often use the word “breakthrough” but this is one of those rare occasions
when I am going to.
‘It is extremely rare to see the results of a clinical trial which are quite as compelling as this.’

At present, screening for bowel cancer uses a test which looks for traces of blood in stools and identifies cancer
at an early stage.
It is offered every two years to those in their 60s and 70s and cuts the death rate by 25 per cent.
But experts say the Flexi-Scope procedure would actually prevent cancer. The blood test would still be needed
as it picks up some cancers in parts of the bowel the Flexi-Scope cannot reach.
The study took place in 14 centres nationally. Around 170,000 people aged between 55 and 64 were offered the
Flexi-Scope test or allocated to non-intervention unless they developed symptoms.
Those having the Flexi-Scope test had small polyps removed or were sent for further investigation where
necessary.
After an average of 11 years follow-up, 2,524 were diagnosed with bowel cancer – comprising 1,818 who did not
have a test and 706 who did.
Altogether 727 died of colorectal cancer – 538 of whom had not had the test and 189 who had.
Overall, the test cut the death rate by 43 per cent and incidence of the disease by 33 per cent.
Researchers say the benefits to individuals will accumulate as bowel cancer affects mostly older people, who will
be protected by the cut in lifetime risk. Bowel cancer claims around 16,000 lives a year.

In Britain, people aged 60 to 74 are tested every other year with a fecal blood test. In the U.S., colonoscopies —
20-minute scans of the entire colon that require sedation — are common, even though no trials have proved
they work for cancer screening. Use of the flexi-scope test has plummeted in the U.S. because colonoscopies are
perceived as being better.
To find polyps or to detect cancer early, the American Cancer Society recommends several options for people
over 50: a flexi-scope test, double-contrast barium enema or virtual colonoscopy every five years or a
colonoscopy every 10 years.
"It's not for me to tell governments what to do," said Dr. Wendy Atkin, a professor of surgery and cancer at
Imperial College London, who led the research. "But this is a very big effect, with a very quick and a very cheap
test."
Atkin said the test only needed to be done once because polyps that grow in the bowel appear before age 60 —
so any potentially cancerous growths should be caught if the test is done on people in their fifties. But the test
only works on the lower bowel, so other exams, like the fecal blood test, would still be necessary.
Dr. David Ransohoff of the departments of medicine and epidemiology, University of North Carolina at Chapel
Hill, North Carolina, said the Lancet findings might make doctors rethink whether the less-invasive flexi-scope
test to scan the lower bowel, plus a highly sensitive fecal blood test to scan the upper bowel, could be better
than a colonoscopy. Ransohoff was not linked to the study and wrote an accompanying commentary in the
Lancet.
Ransohoff said the finding the test only needed to be done once in a person's lifetime was "striking" and further
follow-up was necessary to see just how long this protective effect lasts.
Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society, said the study
results would not change their colon cancer screening guidelines.
"We have long included (flexi-scope) tests as one of our preferred tests to prevent disease," he said. "I would
hope clinicians look at this information and recognize there is some value in this test."

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test-halt-bowel-cancer-save-thousands-lives.html