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Bowel screening uses one blood-in-stool threshold for everyone. Setting it by age, sex and the person's previous results would find more cancers with the same number of colonoscopies.
Bowel screening applies one blood-in-stool threshold to everyone, so this idea sets FIT cut-offs and intervals by age, sex and prior results: people with low prior FIT move to three-yearly screening and those with high sub-threshold values are recalled in a year. FIT haemoglobin concentration and previous FIT values strongly predict future advanced neoplasia, and colonoscopy capacity rather than FIT cost is the binding constraint, so risk adaptation should find more cancers with the same number of colonoscopies. The test is a randomised evaluation within a national programme such as the Netherlands with a four-year endpoint. At early-clinical maturity it addresses the bottlenecks The hardest cancers are found late and Overdiagnosis and false alarms.
One bottleneck page and 32 idea pages on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
A colonoscopy probably does reduce bowel cancer risk for the person who has it, but a programme that offers colonoscopy achieves much less if most people decline. Programmes based on stool tests with high uptake may deliver as much population benefit at lower cost and risk.
A cheap home stool test, repeated yearly or every two years and followed by colonoscopy when positive, prevents bowel cancer deaths. This is what national bowel screening programmes do today, with FIT replacing the older guaiac test.
Shares Early detection of cancer, The hardest cancers are found late.
Shares Early detection of cancer, The hardest cancers are found late.
Shares Early detection of cancer, Overdiagnosis and false alarms, The hardest cancers are found late.
Shares Minnesota trial: a yearly stool blood test cuts bowel cancer deaths by a third, The hardest cancers are found late, Colorectal cancer.
Shares Early detection of cancer, The hardest cancers are found late.
Shares Multitarget stool RNA test (ColoSense), Colorectal cancer.
Shares Early detection of cancer, The hardest cancers are found late.
Shares Early detection of cancer, The hardest cancers are found late.