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Early colon cancer screening test sensitivity

Vancouver – BC Laboratories and BC Cancer have identified an issue with the test used to screen for colon cancer.
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​Recent fecal immunochemical test (FIT) results are showing an increase in the number of positive screens being returned – more patients are testing positive than is typical. This higher rate was detected by the improved monitoring put in place last year, following a similar issue.

"Lab providers and BC Cancer's Colon Screening Program have recently noticed an increase in the percentage of positive screens, which suggests that some borderline negative results are now testing positive," said Dr. Jim Cupples, the vice president, medical for the BC Agency for Pathology and Laboratory Medicine, a clinical division of BC Clinical and Support Services Society. "We are working with our partners including BC Cancer and the Ministry of Health to resolve the issue as quickly as possible."

The issue has been identified as a problem with the liquid solution, known as a reagent, used to test the fecal samples in the labs. A new reagent has been in use since mid-December 2017, when testing resumed after a three-month suspension due to similar issues. The new reagent was performing to expected standards until very recently.

Testing will continue; however, physicians and patients are being informed that there will be a higher percentage of patients than normal who are referred for follow up colonoscopy. The Colon Screening Program recommends all patients with abnormal FIT results have a follow up colonoscopy.

A positive FIT result is common and does not mean that the patient has cancer. On average, 15 per cent of patients screen positive and require further testing. It is expected that an additional 5 per cent of patients will now screen positive whereas previously they would have had a borderline negative result.

"We are working diligently with our partners on a long-term resolution that will ensure British Columbians are able to continue to have trust and confidence in this very important early cancer screening tool," Dr. Cupples added.

"We recognize that a testing suspension like we experienced in the fall, although temporary, may have caused concern or confusion for patients waiting for test results, or who recently received a referral for a FIT," said Dr. John Spinelli, the vice-president of population oncology at BC Cancer.

"Laboratory providers, the Ministry of Health and the Colon Screening Program strongly believe that the best course is to continue with FIT so that no one in need of colonoscopy is missed," said Dr. Spinelli.

BC Laboratories, BC Cancer and the Ministry of Health are actively exploring all options to address this situation as quickly as possible. 

Facts

  • Screening can save lives by detecting non-cancerous polyps and cancer early.
  • Colon cancer is easier to treat when found at an early stage.
  • When detected at its earliest stage, survival rates are approximately 90 per cent.
  • FIT is a routine screening test recommended for men and women between the ages of 50 and 74. It detects blood in the stool, which can be an early sign of colon cancer.
  • The test is designed for people considered at average risk of colon cancer.
  • Screening is only recommended for people who are not experiencing symptoms of colon cancer
    • Symptoms can include blood in your stool, abdominal pain, change in bowel habits, or unexplained weight loss. If you are experiencing these symptoms, talk to your doctor about the diagnostic testing you may need to determine the cause of these symptoms
  • Other factors that put people at greater risk of colon cancer include the following:
    • One first-degree relative (mother, father, sister, brother, daughter or son) with colon cancer diagnosed under the age of 60
    • Two or more first-degree relatives with colon cancer diagnosed at any age
    • A personal history of adenomas

Background

For more information on the colon screening program, visit BC Cancer's screening website at www.screeningbc.ca

BC Clinical and Support Services (BCCSS), part of the Provincial Health Services Authority promotes health in the in the province through coordinating, managing, and/or providing clinical, diagnostic and support services to BC's health care system for the benefit of all users.  BCCSS' Clinical Division includes BC's Agency for Pathology and Laboratory Medicine and the BC Provincial Blood Coordinating Office. BCCSS' Support Services Division includes Supply Chain, Technology Services, and Financial & Employee Services, delivering services to BC's six health authorities. For more information, please visit our website at www.bccss.org.

BC Cancer, part of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. For more information, visit www.bccancer.bc.ca or follow us on Twitter @BCCancer.

The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us on Twitter @PHSAofBC.

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For more information or to arrange an interview, please contact:

Kevin Sauve
Communications Officer, BC Cancer
Provincial Health Services Authority
Phone: 604-877-6436
Email: kevin.sauve@bccancer.bc.ca
PHSA media line: 778-867-7472

 
 
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