RT Journal Article
SR Electronic
T1 A novel blood based triage test for colorectal cancer in primary care: a pilot study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2022.0077
DO 10.3399/BJGPO.2022.0077
VO 7
IS 1
A1 Cerys Jenkins
A1 Freya Woods
A1 Susan Chandler
A1 Kym Carter
A1 Rhys Jenkins
A1 Andrew Cunningham
A1 Kayleigh Nelson
A1 Rachel Still
A1 Jenna A Walters
A1 Non Gwynn
A1 Wilson Chea
A1 Rachel Harford
A1 Claire O'Neill
A1 Julie Hepburn
A1 Ian Hill
A1 Heather Wilkes
A1 Greg Fegan
A1 Peter Dunstan
A1 Dean A Harris
YR 2023
UL http://bjgpopen.org/content/7/1/BJGPO.2022.0077.abstract
AB Background The majority of colorectal cancers (CRCs) are detected after symptomatic presentation to primary care. Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is a pressing need for access to simple triage tools in primary care to help prioritise patients for referral.Aim To evaluate the performance of a novel spectroscopy-based CRC blood test in primary care.Design & setting Mixed-methods pilot study of test performance and GP focus group discussions in South Wales.Method Patients on the urgent suspected cancer (USC) pathway were recruited for the Raman spectroscopy (RS) test coupled to machine learning classification (‘Raman-CRC’) to identify CRC within the referred population. Qualitative focus group work evaluated the acceptability of the test in primary care by thematic analysis of focus group theorising.Results A total of 532 patients aged ≥50 years referred on the USC pathway were recruited from 27 GP practices. Twenty-nine patients (5.0%) were diagnosed with CRC. Raman-CRC identified CRC with sensitivity 95.7%, specificity 69.3% with area under curve (AUC) of 0.80 compared with colonoscopy as the reference test (248 patients). Stage I and II cancers were detected with 78.6% sensitivity. Focus group themes underlined the convenience of a blood test for the patient and the test’s value as a risk assessment tool in primary care.Conclusion The findings support this novel, non-invasive, blood-based method to prioritise those patients most likely to have CRC. Raman-CRC may accelerate access to diagnosis with potential to improve cancer outcomes.