Colorectal cancer – improve the selection of people who should be offered endoscopy

The support offered by The Vissing Foundation to the gastro unit, surgical department, at Hvidovre Hospital co-finances a large clinical project. The purpose is to improve the selection of people who should be offered colonoscopy to identify pre-cancer of or actual colorectal cancer. Since the implementation of screening for colorectal cancer in 2014, the total number of colonoscopy procedures has increased to a stage that leads to excessive waits,” Hans Jørgen Nielsen from Hvidovre Hospital says.

Screening for colorectal cancer is based on a test for occult blood in one’s stool. If this test is positive, colonoscopy is offered in order to determine the source of the blood. The test, however, does not identify all cancers or pre-cancers, and at the same time, subsequent colonoscopy procedures detect cancer or polyps in approx. 35% of the patients. Therefore, many unnecessary colonoscopy procedures are carried out.

On an international level, parallel research is carried out in order to develop a test based on cancer markers in blood tests. Published results show that screening based on blood tests might be an option as a supplement to the stool test.

Research co-operations between 10 hospitals in The Capital Region of Denmark and The Central Jutland Region show that the blood test often identifies other persons with cancer or polyps than the stool test. Therefore, a combination of those two tests seems like a logical step. Initial results have shown that the combination of a stool test and a blood test improves the selection of people who should be offered colonoscopy. In this way, the number of colonoscopy procedures can be reduced by 25-30% and will only be used for those people who definitely have a need for such a procedure. The current clinical project, supported by The Vissing Foundation, will evaluate the combined value of those two methods.