Optimising Colorectal Cancer Patient Pathways
This study looks at how we can better find bowel cancer earlier in Scotland. Bowel cancer is common, and finding it sooner makes treatment more successful. Currently, around 2% of people sent for checks actually have bowel cancer, and many get unnecessary invasive tests. We're testing if taking extra poo samples (called FIT tests) over time can give doctors more information. This could help them decide more accurately who really needs further tests like a CT scan or a camera test (colonoscopy). The goal is to make sure people get the right tests at the right time, improve cancer detection, and reduce long waiting lists for investigations.
At a glance
What is this study about?
Bowel cancer is a serious condition, and it's the fourth most common cancer in Scotland. Sadly, more people die from bowel cancer in Scotland compared to other parts of the UK. We know that finding bowel cancer early makes a huge difference in how well treatment works and how likely someone is to recover. Currently, most bowel cancers are found after someone is referred to a specialist hospital department.
When you're referred by your GP for bowel problems, you're often asked to provide a poo sample for a test called FIT (Faecal Immunochemical Test). This test looks for tiny amounts of blood that you can't see, which might be a sign of bowel cancer. If blood is found, you usually need further checks like a CT scan or a colonoscopy (where a tiny camera looks inside your bowels). However, only a small number of people referred for these checks actually have bowel cancer, meaning many people go through invasive tests unnecessarily, and this also puts a lot of pressure on NHS services, leading to delays for everyone.
This study, based on earlier successful work, is exploring if additional FIT tests, taken over a period, can help doctors get a clearer picture. By seeing how the amount of blood in your poo changes over time, doctors might be able to more accurately work out who really needs a colonoscopy and who can be safely monitored or given different tests. The aim is to pick up more cancers earlier, reduce the number of people having unnecessary colonoscopies, lighten the load on the NHS, and ultimately, improve care for everyone at risk of bowel cancer. We will also collect extra samples to help develop even better tests for the future.
Key takeaways
- Aims to improve early detection of bowel cancer.
- Uses extra poo samples (FIT tests) to help doctors.
- Goal is to make tests more accurate and reduce unnecessary colonoscopies.
- Could help reduce NHS waiting times and improve outcomes.
- Participation involves providing additional home-based samples.
Who may be eligible?
This study is looking for around 1,000 patients in the NHS Lothian area who have been referred to the hospital specialist team because their doctor is concerned about possible bowel cancer symptoms. You would be considered if you have 'red-flag' symptoms – these are specific signs that your doctor might be worried about – and your first poo sample (FIT test) showed traces of blood.
However, there are some reasons why you might not be able to join. For example, if both your first two poo samples showed no blood, or if your doctor found a lump in your tummy or bottom. You also wouldn't be able to join if you've already had bowel cancer in the past, have certain bowel conditions like Crohn's disease or ulcerative colitis, or if you're monitored for growths (polyps) in your bowel. People with known inherited conditions that increase their risk of bowel cancer are also not included.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you in the NHS Lothian area?
- Were you referred by your GP for bowel symptoms they were worried about?
- Did your first poo sample (FIT test) show traces of blood?
- Have you not had bowel cancer or certain other bowel conditions before?
- Have you not been told you have an inherited condition increasing bowel cancer risk?
- Has your doctor not found a lump in your tummy or bottom?
What does participation involve?
If you join this study, your involvement would be quite straightforward. After being referred by your GP for bowel symptoms, you would be asked to provide some extra poo samples for testing (FIT tests), in addition to the samples you would usually provide. You would be given instructions on how to collect these samples at home and return them to your GP surgery. The study involves looking at how the levels of blood in your poo samples change over time. The exact number of extra samples or the timeframe for collecting them would be explained to you in detail if you are eligible.
The main aim is to understand if these extra tests help doctors decide the best next steps for your care. There are no additional hospital visits specifically for the study beyond what your doctors already plan for your condition. Your overall care pathway and any necessary examinations (like scans or colonoscopies) or treatments would continue as normal, guided by your doctors. The study itself doesn't involve any new medications. The total duration of your participation would be based on the timeline for collecting the additional samples and how your doctors are monitoring your condition, which would be explained before you decide to take part.
Potential risks and benefits
Locations (1)
- NHS LothianVerified postcodeEdinburgh, United Kingdom
Common questions
What is a FIT test?
A FIT test is a simple test where you provide a small sample of your poo, which is then checked for tiny amounts of blood that you can't see. This blood might be a sign of bowel problems, including bowel cancer.
Why is this study important for people in Scotland?
Bowel cancer rates are high in Scotland, and finding it early is key. This study aims to make the testing process better and more efficient in Scotland, helping more people get the right diagnosis and care sooner.
Will taking part in the study change my treatment?
No, your medical treatment will be decided by your doctors based on your condition, just as it would normally be. This study is about improving the tests that help guide those decisions in the future for everyone.
Do I have to go to hospital for this study?
Not specifically for the study. You will provide extra poo samples from home. Any hospital appointments you have would be part of your usual medical care, not extra visits for the study.
What happens if I change my mind after joining?
You are free to leave the study at any time without giving a reason. Your decision will not affect your medical care in any way.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
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