We asked SCPN friends and advisors to tell us about a report/paper/findings/work on cancer screening and prevention that has been published this year and has made them stop and think. The works span a wide range of areas from very detailed scientific investigation, reviews of physical activities, and blogs of model work. We find them a complete inspiration. When only 3% of the NCRI research budget is spent on prevention and virtually nil on implementation research; these papers provide a window on some of the very good reasons why cancer screening and prevention should be a leading part of cancer control research.

callum fraser

Professor Callum G Fraser has worked in laboratory medicine in Scotland and Australia for more than 47 years. He has published 2 monographs, 14 book chapters and well over 300 papers, editorials and reviews. He has been involved with faecal testing since 1998, is Senior Research Fellow in the Centre for Research into Cancer Prevention and Screening, and is a Founding Member of the Expert Working Group on FIT for Screening, CRCSC, World Endoscopy Organization.

Callum’s nominated paper of the year is: Grobbee EJ, et al. (2017) ‘Association between concentrations of hemoglobin determined by fecal immunochemical tests and long-term development of advanced colorectal neoplasia’ in Gastroenterology, 153 (2): 1251-9.

Callum chose this paper because…

“Colorectal cancer (CRC) screening is now often performed with FIT as a positive/negative investigation, with a single faecal haemoglobin (f-Hb) cut-off to decide who to refer for colonoscopy. These authors investigated the association between f-Hb below the cut-off applied in the pilot in The Netherlands (10 µg Hb/g faeces) and the development of advanced colorectal neoplasia (AN). After eight years of follow-up, participants with f-Hb 8-10 μg f Hb/g faeces had a higher cumulative incidence of AN (33%) than participants with 0 μg Hb/g faeces (5%). Participants with two consecutive f-Hb 8 μg Hb/g faeces had a 14-fold increase in risk of AN compared with those with two consecutive f-Hb 0 μg Hb/g faeces.

This paper provides evidence that low but detectable f-Hb confers increased risk and much supports further exploration of the concept that “precision medicine” could be adopted with advantage in CRC screening programmes, perhaps even in Scotland, which uses a much higher f-Hb cut-off because colonoscopy is a scarce resource.”

Read the paper here: http://www.gastrojournal.org/article/S0016-5085(17)35965-6/fulltext

If you experience any difficulties accessing the paper, please don’t hesitate to get in touch with us at scpn@cancerpreventionscotland.org.uk