Research

A novel blood based triage test for colorectal cancer in primary care: a pilot study

Cerys Jenkins, Freya Woods, Susan Chandler, Kym Carter, Rhys Jenkins, Andrew Cunningham, Kayleigh Nelson, Rachel Still, Jenna A Walters, Non Gwynn, Wilson Chea, Rachel Harford, Claire O'Neill, Julie Hepburn, Ian Hill, Heather Wilkes, Greg Fegan, Peter Dunstan and Dean A Harris
BJGP Open 13 December 2022; BJGPO.2022.0077. DOI: https://doi.org/10.3399/BJGPO.2022.0077

Article Figures & Data

Figures

  • Figure 1.
    Figure 1. Study design. The mixed -methods prospective clinical validation study incorporated a retrospective cohort analysis to build the Raman-model, the prospective study for clinical validation, and a nested qualitative study for investigating attitudes of the test in primary care. USC = urgent suspected cancer; CRC = colorectal cancer. USC = urgent suspected cancer.
  • Figure 2.
    Figure 2. Disease prediction for the prospective validation cohort from secondary care urgent suspected cancer (USC) referral patients. Overall sensitivity, specificity, false negative rate, and false positive rate for the Raman-CRC model on a colonoscopy per-patient basis following blind analysis.

    CRC = colorectal cancer.

  • Figure 3.
    Figure 3. Proposed new clinical pathway incorporating Raman-CRC testing as a triage tool in primary care. Symptomatic patients with a negative Raman-CRC test are reassured in primary care, relieving pressure on secondary care diagnostic services. The pathway could lead to earlier diagnosis and a reduction in time to treatment when a positive test is combined with a straight to test pathway. CRC = colorectal cancer.

Tables

  • Table 1. Disease prediction for the prospective validation cohort from secondary care USC referral patients. Test sensitivity and specificity (95% confidence intervals according to initial diagnostic test)
    n, totalSensitivitySpecificity
    Colonoscopy24895.7 (78.1% to 99.9%)69.3 (63.8% to 76.1%)
    Colonoscopy and CTC40589.7 (72.7% to 97.8%)65.7 (60.7% to 70.5%)

    • CTC = computed tomography colonoscopy. USC = urgent suspected cancer.

  • Table 2. Raman-CRC model performance for different cancer stages versus FIT
    Sensitivity for UICC guidance stages
    StageIIIIIIIV
    Raman-CRC50% (n = 4)90% (n = 10)100% (n = 12)100% (n = 3)
    FIT27 73% (65%–79%)80% (74%–84%)82% (77%–87%)79% (70%–86%)

    • CRC = colorectal cancer. FIT = faecal immunochemical test.

  • Table 3. Comparison of Raman-CRC test performance with NG12 pathway and FIT
    NICE NG12 pathway3FIT (threshold 10 µg/g)7Raman-CRC
    Sensitivity9390.995.7
    Specificity3583.569.3
    AUCn/a0.930.8

    • AUC = area under curve. CRC = colorectal cancer. FIT = faecal immunochemical test. NICE = National Institute for Health and Care Excellence.

Supplementary Data

  • Harris_BJGPO.2022.0077_Supp.docx -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
Back to top

Latest Articles

Download PDF
Download PowerPoint
Article Alerts
Email Article
Citation Tools
A novel blood based triage test for colorectal cancer in primary care: a pilot study
Cerys Jenkins, Freya Woods, Susan Chandler, Kym Carter, Rhys Jenkins, Andrew Cunningham, Kayleigh Nelson, Rachel Still, Jenna A Walters, Non Gwynn, Wilson Chea, Rachel Harford, Claire O'Neill, Julie Hepburn, Ian Hill, Heather Wilkes, Greg Fegan, Peter Dunstan, Dean A Harris
BJGP Open 13 December 2022; BJGPO.2022.0077. DOI: 10.3399/BJGPO.2022.0077
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo

Jump to section

Keywords

Intended for Healthcare Professionals

 
 

British Journal of General Practice