Personalised stool-test cut-offs by age, sex and prior results
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.
FIT haemoglobin concentration and prior FIT values strongly predict future advanced neoplasia. Propose risk-adapted FIT thresholds and intervals (low prior FIT to three-yearly; high sub-threshold FIT to recall in one year), tested within a national programme.
- Most lethal cancers are found late · Screening exists for only a few cancers. Pancreatic, ovarian, liver, oesophageal and most lung cancers are found when cure is unlikely.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
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.
Pages like this
not linked directly; found by shared links- TermFaecal immunochemical test (FIT)
Shares Minnesota trial: a yearly stool blood test cuts bowel cancer deaths by a third, NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected, Most lethal cancers are found late, Colorectal cancer.
- IdeaMRI-first prostate screening with genetic pre-selection
Shares Overdiagnosis and false alarms, Most lethal cancers are found late.
- IdeaA urine DNA test to decide who with blood in the urine needs a camera test
Shares Overdiagnosis and false alarms, Most lethal cancers are found late.
- PersonStephen Sutton
Shares Most lethal cancers are found late, Colorectal cancer.
- TrialNLST & NELSON (low-dose CT screening)
Shares Overdiagnosis and false alarms, Most lethal cancers are found late.
- IdeaSet each woman's mammogram interval from her last mammogram, using AI risk
Shares Overdiagnosis and false alarms, Most lethal cancers are found late.
- IdeaUse a polygenic risk score to set when screening starts
Shares Most lethal cancers are found late, Colorectal cancer.
- IdeaEvery routine CT scan checked by AI for early cancer signs, with a tracked follow-up pathway
Shares Overdiagnosis and false alarms, Most lethal cancers are found late.