Included below are news items from the last six months.
Improvements recommended for NHS screening programmes that use laboratory tests for bowel cancer, cervical cancer and Down’s syndrome
The UK National Screening Committee published recommendations on 15 January 2016 for improvements to three of the NHS screening programmes that use lab tests. The committee advised that
- a faecal immunochemical test (FIT) should replace the guaiac occult blood test as the primary test for bowel cancer because it detects more cases and is easier to use.
- a test for human papilloma virus (HPV) should replace the liquid cytology test as the first line screen for cervical cancer because it is more accurate.
- a non-invasive prenatal test (NIPT) on maternal blood should be evaluated as a second screen for pregnant women whose initial screen suggests their baby has an increased chance of having Down’s syndrome. NIPT greatly improves accuracy, so that fewer women would need an invasive procedure to make a firm diagnosis.
The large UK Collaborative Trial of Ovarian Cancer Screening in post-menopausal women reported mortality figures after up to 14 years follow-up online in the Lancet on 17 December 2015. The researchers concluded that annual monitoring of CA-125 concentration followed by ultrasound examination when indicated could reduce mortality from ovarian cancer by about 20%, but that further follow-up is needed before firm conclusions can be reached on the long-term efficacy and cost-effectiveness of screening.
A recent study published in the New England Journal of Medicine describes a 21-gene test performed on tumour tissue removed from women with certain types of breast cancer. Results suggest that the test can accurately predict those women who will do well with hormone treatment, without the need for chemotherapy.
Researchers carried out high-sensitivity cardiac troponin blood tests on 4,870 patients arriving as emergencies at four Scottish hospitals with a suspected heart attack. Their retrospective analysis of the results was reported online in The Lancet on 8 October 2015. In the 3,799 patients who had no electrocardiogram (ECG) evidence of a heart attack and a normal troponin test result on admission, the researchers identified a specific troponin concentration within the normal reference range, below which 99.6% of the patients were not subsequently diagnosed with a heart attack and had therefore been eligible for early discharge. It is hoped that using this approach will substantially reduce hospital admissions and have major benefits for both patients and health-care providers.