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Recently, the Centre for Health Protection published the annual statistics of the Hong Kong Colorectal Cancer Screening Programme. As of the end of 2024, only over 40% of eligible individuals aged 50 to 75 had undergone colorectal cancer screening[1]. Although this is a significant increase from about 33% ten years ago, there is still room for improvement. The report also noted that among those who tested positive in the fecal immunochemical test (FIT) and underwent colonoscopy, the programme detected approximately 3,400 cases of colorectal cancer and about 40,000 cases of colorectal adenoma. Nearly 56% of the colorectal cancer cases diagnosed through the programme were early-stage cancers with a higher cure rate.
Colorectal cancer is a common and preventable cancer, yet over 75% of patients who died from colorectal cancer had never been screened. Early-stage colorectal cancer often has no symptoms, and the most reliable method is regular screening[2].
Currently, the Hong Kong government's "Colorectal Cancer Screening Programme" subsidizes eligible individuals to undergo a fecal occult blood test (FOBT), which uses chemical or immunochemical methods to detect trace amounts of blood in stool samples, followed by a doctor's review of the results[1]. If the FOBT result is positive, participants are referred to a participating colonoscopy doctor for a government-subsidized colonoscopy.
For those who do not wish to handle stool samples or are not eligible for the free screening programme, a blood-based circulating tumor DNA (ctDNA) test is an alternative to quickly and conveniently assess the risk of colorectal cancer.
The ctDNA test detects circulating tumor DNA in the blood to identify colorectal cancer at an early stage. Guardant Health's Shield is one such ctDNA colorectal cancer screening test available for order in Hong Kong. In the ECLIPSE study, over 10,000 patients aged 45 to 84 provided blood samples for testing, and the results showed that Shield had an 83% sensitivity for colorectal cancer and a specificity of up to 90%. Recently, the Guardant Health team conducted another study with 623 blood samples, achieving a sensitivity of 93% and a specificity of 90%. These findings were published in the December 2023 issue of the Annals of Oncology. This demonstrates that even a simple blood test can have screening accuracy comparable to the FOBT.
Guardant Shield™ received FDA approval on July 29, 2024, for colorectal cancer screening in adults aged 45 and older with average risk for the disease.
For more information about Shield, you can contact us via WhatsApp.
Refernece：
［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
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