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10/04/17

No replacement for B.C. colon cancer screening tests — yet

The B.C. Cancer Agency said Wednesday it will not seek a new supplier of early detection colon cancer tests until it has exhausted efforts to resolve problems related to the test that has now been suspended due to defects that abruptly caused a surge in false positive results.

Cancer screening experts noticed in the summer that there was a sudden surge in the number of false positives related to the fecal immunochemical test (FIT) that has been in use for four years. So on Tuesday, the cancer agency announced it was suspending such tests.

If the problems cannot be resolved, a new supplier could be used but agency spokeswoman Amy Robertson said it is too early to say if that will happen. B.C. appears to be the lone province experiencing problems with the accuracy of the tests. Provinces all use different stool testing kits.

It is believed the problem lies in the liquid solution used in labs to analyze the tests. The solution and the test kits are supplied by a company called Alere which announced this week that it has been acquired for $5.8 billion by pharma giant Abbott.

Calls to officials at Abbott were not returned.

Dr. Trina Larsen Soles, president of Doctors of B.C. said she’s concerned but recognizes the need for a reliable test.

“The degree of my angst is directly proportional to the length of time it will take to solve the problem. Let’s hope there is a timely solution because no one wants to see cancer in someone that could have been prevented or at least detected much earlier.”

Meanwhile, the B.C. Ministry of Health says it will assist health authorities to mitigate waiting times for colonoscopies. That implies that extra resources will be directed to health regions to increase available hospital space and health professionals involved in the provision of colonoscopies. The colon cancer screening program has been beset from the outset with shortages of resources and long waits for colonoscopies. About 126,000 colonoscopies were conducted last year in those at risk for cancer. Guidelines state that individuals should not wait more than 60 days for the procedure if they have symptoms of cancer.

Laura Heinze, a spokeswoman for the health ministry, said:

“The ministry has been working closely with the Colon Screening Program and with Life Labs and the other laboratories. The program is a very important public health initiative as screening can detect the early warning signs of colon cancer and save lives. We are determined to resume with the screening program as soon as possible. We will continue to work with the program and with health authorities, to minimize any impacts to patients and mitigate any increase in waiting times for colonoscopy.”

She said individuals should be aware that screening is for those without any symptoms of colon cancer and colonoscopies are for those with symptoms. Several B.C. residents have told Postmedia that they have recently received positive results after doing FIT testing. The positive results suggest there is an abnormality and that individuals require colonoscopies for which they are now waiting. One reader in her 60’s, who asked to remain anonymous, said the test was effective in her case because a followup colonoscopy indicated she did indeed have polyps which can become cancerous.

“Was my test a false positive? I don’t know, but the gastroenterologist found and removed three polyps, which is a very good thing, as polyps will become cancerous eventually. I was told I need another colonoscopy in a few years. So maybe my test was a true positive?” she said in an email.

Colon cancer is the second most common cancer in B.C. men and the third most common in B.C. women. This year, an estimated 3,600 B.C. residents will be diagnosed with colorectal cancers and about 1,300 will die from them. Nearly 500,000 B.C. residents have been screened (with stool tests) since the program began almost five years ago. About 20,000 B.C. residents have been getting screened each month with the FIT test and 4,000 each month go for colonoscopies. Colonoscopies are said to reduce deaths from colorectal cancer by 60 to 70 per cent. The procedure comes with a slight risk (one in 1,000) of bleeding or perforation.

A one-year anniversary report on the screening program showed that only one per cent of patients who got a colonoscopy after an abnormal stool test were found to have cancer. But two-thirds had polyps ranging from low to high risk.

The cancer agency has posted a question and answer document on its website which can be accessed here.


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Source: http://vancouversun.com/news/local-news/no-replacement-for-b-c-colon-cancer-screening-tests-yet