• Posted February 12, 2024

New Stool Test May Spot More Colon Cancers Sooner

Dutch researchers have developed a new stool test that appears to detect colon polyps better than the current test does.

"The current test performs well, but leaves room for improvement," said Dr. Gerrit Meijer, principle investigator at the Netherlands Cancer Institute in Amsterdam. 

"We want to be able to detect the tumors before they have become invasive, that is at the stage of larger premalignant polyps," he added in an institute news release. "Treating physicians then can remove these polyps during a colonscopy, rather than by surgery."

That could save thousands of lives worldwide. Each year, an estimated 1.9 million people around the world are diagnosed with colon cancer, and the disease claims 935,000 lives. It is curable if detected early.

In many countries with population-wide colon cancer screening programs, the fecal immunochemical test (FIT) is used. It measures the presence of the blood protein hemoglobin.

Meijer and his team have been working on a new test for years. Their multitargetFIT-test (mtFIT) measures hemoglobin as well as two other proteins. 

In the Feb. 9 issue of the Lancet Oncology, they reported on a comparison of the two tests in more than 13,000 participants in the Dutch national screening program. 

"The new test can detect cancer precursors more effectively," Meijer said. "Our results predict that the test can reduce the number of new cases of colorectal cancer and [death rates] resulting from it." 

The new test is as easy to use as the current one. 

It found abnormalities in 299 people, compared to 159 who used the current FIT test. The difference mainly involved a high-risk precursor of cancer. 

"The new test detects more larger polyps without a significant increase in 'false-positve' results and thus unnecessary colonscopies," Meijer said.

How many cases of colon cancer could be prevented with the new test is unclear. Researchers said that depends on how different countries use the current FIT test.

Based on cutoffs used in The Netherlands, the new test could cut colon cancer cases by 21% and deaths by 18%, Meijer said. 

In countries that already use a lower cutoff, the figures would be lower. Meijer estimated that "at least 5% fewer people" would develop colon cancer and death rates would drop at least 4%. 

"In both scenarios, the new test could be cost-effective," he said.

It won't go into use right away, however.

"The critical next step is to produce the test at an industrial scale according to European diagnostic test guidelines," Meijer said.

A new company, CRCbioscreen, has been launched to do so.

More information

The U.S. Centers for Disease Control and Prevention has more about colon cancer screening tests.

SOURCE: Netherlands Cancer Institute, news release, Feb. 9, 2024