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New NICE guidance will help GPs identify colorectal cancer

NICE has recommended that patients with signs or symptoms of colorectal cancer are offered home tests.

NICE has recommended that patients with signs or symptoms of colorectal cancer are offered home tests, which could lead to faster diagnosis and fewer people referred to secondary care for an unnecessary colonoscopy.

The guidance recommends quantitative faecal immunochemical tests (FIT) from one of two technologies (HM-JACKarc or OC-Sensor). The results are usually available within a week and people with 10 or more micrograms of haemoglobin in their faeces should then be referred for further investigation.

Analysis carried out by NICE shows if there is a 25% reduction in the number of people referred, 94,291 fewer colonoscopies would take place.

Under previous NICE guidance, FIT was already offered to some people presenting to primary care with symptoms suggestive of colorectal cancer, while others were immediately referred on the suspected cancer pathway.

For people where there is strong clinical concern of cancer because of ongoing unexplained symptoms, the guidance remains to refer them immediately to secondary care.

42,000 cases of colorectal cancer each year

Mark Chapman, interim director of medical technology and digital evaluation at NICE, said: “Our recommendations can help around 100,000 people avoid having a colonoscopy when an at home test could rule out the need for one and at the same time free up waiting lists to diagnose those more likely to have colorectal cancer.

“Colorectal cancer is the fourth most common cancer in the UK. These recommendations ensure we are balancing the best care with value for money, while at the same time delivering both for individuals and society as a whole.”

The tests cost the NHS between £4 and £5 per sample and can correctly identify about 9 out of 10 people with colorectal cancer.

The committee agreed it is important that GPs can refer people for colonoscopy without a positive FIT result if they think it is necessary and where symptoms persist.

Genevieve Edwards, chief executive at Bowel Cancer UK, added: “Those with low risk symptoms, especially younger people, often face a delayed diagnosis or have to see their GP a number of times before being referred for further tests.

“This guidance will help GPs to better identify and refer the right patients for further testing quickly and could help detect bowel cancer at an earlier stage when it is more treatable and curable.”

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