Globally, around 1.9 million people are diagnosed with colorectal cancer each year, resulting in approximately 935,000 deaths. Early detection is key, as colorectal cancer can be cured if found early. However, symptoms like weight loss or blood in the stool often emerge too late for effective intervention. Consequently, many countries have initiated population-based screening programs. These programs commonly utilize the fecal immunochemical test (FIT), which detects the blood protein hemoglobin in stool samples. Colorectal cancer screening programs have been effective in diagnosing the disease at earlier stages and reducing mortality rates. Despite the current test’s effectiveness, there is a need for improvement, particularly in detecting larger premalignant polyps before they become invasive. Early detection would allow for these polyps to be removed during a colonoscopy instead of requiring surgery.

Researchers at the Netherlands Cancer Institute (Amsterdam, the Netherlandsl) have been developing a new test, the multitargetFIT-test (mtFIT), which measures hemoglobin and two additional proteins. An earlier retrospective study showed promising results. Now, a much larger, prospective study that compared the mtFIT to the current FIT in over 13,000 participants of the Dutch national population-based screening program has found that the new test yielded more positive results than the current test. This increase in positive results led to more colonoscopies being performed.

With the new mtFIT test, doctors found abnormalities in 299 individuals, compared to 159 individuals with the current FIT test. Most notably, the mtFIT identified a higher number of individuals with high-risk precursors to colon cancer (216 versus 114). The potential number of colorectal cancer cases that could be prevented using this new test varies, depending on how the current FIT test is implemented in different countries. For participants, the new test is as user-friendly as the existing one. Integrating mtFIT into existing FIT-based screening programs should be easy, as both tests require similar screening logistics.

“The new test can detect cancer precursors more effectively,” said Gerrit Meijer, Principal Investigator at the Netherlands Cancer Institute. “Our results predict that the test can reduce the number of new cases of colorectal cancer and mortality resulting from it. The new test detects more larger polyps without a significant increase in 'false-positive' results and thus unnecessary colonoscopies.”