Shining the Spotlight: Bowel Cancer Awareness Month 2024

Over the last 20 years, bowel cancer survival rates have only seen modest improvements, with just over half of patients now surviving 5 years or more. Compared with other common cancer types, such as breast cancer (almost 9 out of 10 patients survive 5 years), there is clearly significant room for improvement when it comes to bowel cancer.

Importantly, the chances of surviving bowel cancer are hugely affected by how early the cancer is detected – fewer than 1 in 10 patients with Stage IV disease survive for 5 years, versus well over 90% of patients with Stage I. Therefore, by the far the most impactful way of improving bowel cancer survival rates moving forward will be to improve early diagnosis rates.

Screening - Issues and Potential

Detection of bowel cancer typically comes following either presentation to the GP with symptoms or a positive result from a bowel cancer screening test. In this blog, we will focus on screening for bowel cancer – however, you can read more about our research that is improving cancer diagnosis in primary care here.

Cancer screening can be an excellent tool for improving patient outcomes, detecting cases of cancer before symptoms have developed. However, in the case of bowel cancer, screening has not yet delivered a transformative impact.

Currently, bowel cancer screening in Wales relies on the Faecal Immunochemical Test (FIT), which detects traces of blood in stools – a home testing kit is sent to all members of the public between the ages of 51 and 74, every two years. Unfortunately, the figures show that only around 60% of eligible people actually use and return their kit, meaning that well over 1 in 3 people are not taking part in the screening. This represents a huge missed opportunity, with early-stage cancers (and even pre-cancerous polyps) going undetected unnecessarily. Several factors play a role in the disappointing uptake figures, but perhaps most important is the perceived unpleasant nature of using the FIT kit at home – improving uptake will likely require a test that is more acceptable to the general public.

COLOSPECT

Cancer Research Wales is currently funding a trial called COLOSPECT, based at Swansea University, which is aiming to address this very issue. This trial is making use of the Raman blood test, an innovative method of detecting bowel cancer which Cancer Research Wales has funded over a number of years.

The COLOSPECT trial is designed to understand whether the Raman blood test could be a better option for use in bowel cancer screening. The team will recruit 2000 people from across Wales who are referred for a colonoscopy following a positive result from their FIT screening kit and will analyse blood samples from these people. The goal is to determine the accuracy with which the Raman test can detect cancer and also rule out a cancer diagnosis. This latter point is important because it means unnecessary colonoscopies can be avoided, helping to reduce the waiting list which currently stands at over 7700.

The long-term aim of this work is to show that the Raman blood test is a better, more accurate tool for bowel cancer screening than the FIT home testing kits. This would pave the way for routine blood tests to replace FIT kits. Work that the team has conducted has shown that the public are very much in favour of this approach and strongly prefer the idea of a blood test – this suggests that uptake of screening would improve compared with the currently disappointing figures, helping to catch cancers earlier and save more lives.

Hope for the Future

Bowel cancer survival rates are excellent in patients whose disease is found at an early stage, but all too often patients are not diagnosed until the cancer has developed to a late stage. Enhancing the accuracy and uptake of screening promises to change this paradigm, detecting bowel cancer early and improving patient outcomes. Here at Cancer Research Wales, we are eagerly anticipating the results of the COLOSPECT trial, which has already recruited over 400 patients and has the potential to be the first step towards transforming bowel cancer screening in Wales for the better.

Our work would not be possible without the fantastic support of the Welsh public, so a huge thank you to all of our supporters. Learn more about how you can get involved here.