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March is Colorectal Cancer Awareness Month every year. Colorectal cancer is the second most common cancer in Hong Kong. According to data released by the Centre for Health Protection of the Hong Kong Department of Health on December 14, 2023, colorectal cancer accounted for 15.3% of all new cancer cases in Hong Kong in 2021[1].
Colorectal cancer is a common and preventable disease, yet more than 75% of patients who die from colorectal cancer have not been screened[2]. There are no symptoms in the early stages of colorectal cancer, and the most reliable method of detection is regular colorectal cancer screening.
Regular screening for early detection and treatment of potential problems
Current screening methods include:
Fecal Occult Blood Test (FOBT) The FOBT is a common colorectal cancer screening method available on the market, and the Hong Kong government has established the “Colorectal Cancer Screening Programme” to subsidize eligible individuals to receive the FOBT, followed by a doctor’s review of the results. If the FOBT result is positive, the individual will be referred by a doctor for a colonoscopy. Eligible individuals for the government’s “Colorectal Cancer Screening Programme”:
The program is applicable to Hong Kong residents aged between 50 and 75 years old who have no apparent symptoms.
*Must hold a Hong Kong Identity Card or Certificate of Exemption
*Must be enrolled in the Electronic Health Record Sharing System
Excludes individuals with symptoms of colorectal cancer, high-risk factors, or those who have undergone colorectal cancer screening or examination within a specified period *For details, please refer to the “Colorectal Cancer Screening Programme” website: https://www.colonscreen.gov.hk/tc/public/index.html [4]
Circulating Tumor DNA (ctDNA) Test in Blood In addition to the FOBT, the latest technology involves detecting circulating tumor DNA in the blood for early detection of colorectal cancer.
Guardant Health’s Shield is one of the blood ctDNA colorectal cancer screening tests that can be ordered in Hong Kong. In the ECLIPSE study, over 10,000 patients aged between 45 and 84 provided blood samples for testing. The results showed that Shield has an 83% sensitivity for detecting colorectal cancer and up to 90% specificity[5-6]. Recently, the Guardant Health team recruited another 623 blood samples for study, and Shield’s sensitivity reached 93%, with a specificity of 90%. These study results have been published in the December 2023 issue of the journal “Annals of Oncology”[7]. This shows that even a simple blood test can have a screening accuracy comparable to the FOBT.
For more information about Shield, please refer to the Shield product description page or contact us via Whatsapp.
In fact, regardless of which colorectal cancer detection method is chosen, the most important thing is to undergo regular checks to detect and treat the disease early. Through screening, we can detect potential colorectal cancer early and increase the chances of successful treatment.
If you are 50 years or older and asymptomatic, it is recommended to undergo regular colorectal cancer screening. Remember, early detection and treatment of colorectal cancer are crucial for preventing the worsening of the disease.
References:
[2] Doubeni CA, Fedewa SA, Levin TR, et al. Modifiable failures in the colorectal cancer screening process and their association with risk of death. Gastroenterology. 2019;156(1):63-74. doi:10.1053/j.gastro.2018.09.040
[3] National Cancer Institute. Cancer Stat Facts: Colorectal Cancer. Cancer.gov website. Accessed July 24, 2023.
[5] Guardant Health announces positive results from pivotal ECLIPSE study evaluating a blood test for the detection of colorectal cancer. December 15, 2022. Accessed December 15, 2022. https://investors.guardanthealth.com/press-releases/press-releases/2022/Guardant-Health-announces-positive-results-from-pivotal-ECLIPSE-study-evaluating-a-blood-test-for-the-detection-of-colorectal-cancer/default.aspx
[6] Chung, D.C., Gray, D.M. II, Singh, H., Issaka, R.B., et al. (2024). A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening12. The New England Journal of Medicine, 390(973-983). doi:10.1056/NEJMoa2304714
[7] Bessa, X., Vidal, J., Balboa, J.C., Castells, X., Bellosillo, B., Montagut, C., et al. (2023). High accuracy of a blood ctDNA-based multimodal test to detect colorectal cancer1. Annals of Oncology, 34(12), 1187-1193. https://doi.org/10.1016/j.annonc.2023.09.3113
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