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A smarter way to fight colorectal cancer

Colorectal cancer is a major burden for Europeans and for our health systems. More than 300,000 people in the EU are diagnosed with the disease every year. Sadly, outcomes are sometimes poor: an estimated 150,000 people die from colorectal cancer annually.

This blog is part of the Early Diagnosis campaign #BeFirst

Early diagnosis and care can prevent illness from developing and slow disease progression. Lab tests, genetic tests, tests for chronic diseases and modern lab diagnostics can help facilitate earlier intervention and improves outcomes for patients and are increasingly valuable in informing treatment choice. 
 

 

Patients can also endure fatigue, pain, insomnia and significant gastrointestinal discomfort. This, in turn, places significant strain on families as well as adding pressure to health systems.

As with all cancers, early and accurate diagnosis can help doctors to intervene early and improve outcomes for patients. This has prompted several European countries to introduce bowel screening programme in an effort to catch the early signs of disease at the point where treatment is most likely to work.

From a purely economic perspective, cancer screening is worthwhile, when implemented properly, helping health systems to avoid costs associated with treatment and improving the chances that people affected will be able to continue contributing to their communities and the economy.

For patients, early diagnosis is priceless.

Still, new technologies can help to improve the efficiency of screening programmes – and make the experience less demanding for patients.

People whose bowel screening shows possible warning signs of cancer are referred for a colonoscopy. Most of these are healthy individuals who do not have colon cancer but need to be checked out. Colonoscopies play a vital role in the early detection of polyps before they develop into cancer, allowing for on-the-spot removal of potentially dangerous lesions.

There are two main types of lesions that may be present. The most common type, hyperplastic polyps, are benign – they pose no cancer risk. The other type, adenomatous polyps, needs to be removed since they may develop into cancer.

For doctors performing a colonoscopy, the trick is to determine whether they are looking at the kind of lesion that poses a serious threat. Because it is difficult to be sure, the standard practice is to remove all polyps and send them to the pathology lab for analysis. Most polyps below a certain size are benign, so their removal puts the patient at unnecessary risk of procedure. In addition, itis not efficient to send all samples to the histopathology lab.

However, new technology – known as narrow-band imaging (NBI) – allows for in-vivo optical diagnosis. This means that the clinician, once they are trained in using the system, can accurately decide whether it is necessary to remove the lesion and send a sample to the lab.

Saving resources and lives

Not only does NBI save time and money by optimising the diagnostic process without compromising the diagnostic result, it spares patients the stress of waiting and wondering whether their lab results will come back positive.

The benefit for clinics and healthcare budgets are also profound. By using this technology, doctors can reduce unnecessary sampling, freeing healthcare workers and laboratory technicians do provide other services. 

In the UK, guidelines from the National Institute for Clinical Excellence (NICE) recommend using NBI so as to reduce unnecessary interventions. A recent publication demonstrated a cost saving of £141 million to the NHS over 7 years due to the use of narrow-band imaging. The main barriers to more widespread use of this approach is the need for physician training programmes and to update clinical guidelines to reflect advances in the field.

In the Netherlands, this approach has indicated to save around €97 in lab and staff costs for every histology exam that is avoided. A further €36 is saved for each polyp resection that is avoided. This all add up to around €50,000 per year in a hospital scenario

If this can be achieved, the latest waves of medtech innovation in the field of cancer diagnostics promises to unlock major value for patients and the health system – making colorectal cancer screening more cost-efficient and freeing resources that are needed to cope with a growing patient population.