Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population
<p style="text-align:justify;"> <b>Background:</b> Bowel cancer is common and is a major cause of death. Meta-analysis of randomised controlled trials estimates that screening for colorectal cancer using faecal occult blood (FOB) test reduces mortality from colorectal ca...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2006
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| _version_ | 1797101738038132736 |
|---|---|
| author | Wilson, S Wakelam, M Hobbs, R Ryan, A Dunn, J Redman, V Patrick, F Colbourne, L Martin, A Ismail, T |
| author_facet | Wilson, S Wakelam, M Hobbs, R Ryan, A Dunn, J Redman, V Patrick, F Colbourne, L Martin, A Ismail, T |
| author_sort | Wilson, S |
| collection | OXFORD |
| description | <p style="text-align:justify;"> <b>Background:</b> Bowel cancer is common and is a major cause of death. Meta-analysis of randomised controlled trials estimates that screening for colorectal cancer using faecal occult blood (FOB) test reduces mortality from colorectal cancer by 16%. However, FOB testing has a low positive predictive value, with associated unnecessary cost, risk and anxiety from subsequent investigation, and is unacceptable to a proportion of the target population. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with colorectal cancer, and this can be measured from a blood sample. Serum MMP-9 is potentially an accurate, low risk and cost-effective population screening tool. This study aims to evaluate the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population.<br/><br/> <b>Methods/Design:</b> People aged 50 to 69 years, who registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that asks about symptoms. Respondents who describe any colorectal symptoms (except only abdominal bloating and/or anal symptoms) and are prepared to provide a blood sample for MMP9 estimation and undergo a colonoscopy (current gold standard investigation) will be recruited at GP based clinics by a research nurse. Those unfit for colonoscopy will be excluded. Colonoscopies will be undertaken in dedicated research clinics. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the colonoscopy findings, and the combination of factors (e.g. symptoms and MMP-9 level) that best predict a diagnosis of malignancy (invasive disease or polyps) will be determined.<br/><br/> <b>Discussion:</b> Colorectal cancer is a major cause of morbidity and mortality. Most colorectal cancers arise from adenomas and there is a period for early detection by screening, but available tests have risks, are unacceptable to many, have high false positive rates or are expensive.<br/><br/> This study will establish the potential of serum MMP-9 as a screening test for colorectal cancer. If it is confirmed as accurate and acceptable, this serum marker has the potential to assist with reducing the morbidity and mortality from colorectal cancer. </p> |
| first_indexed | 2024-03-07T05:56:07Z |
| format | Journal article |
| id | oxford-uuid:ea8c7c47-64a5-41ee-a3ee-4d645fdf5630 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:56:07Z |
| publishDate | 2006 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:ea8c7c47-64a5-41ee-a3ee-4d645fdf56302022-03-27T11:03:11ZEvaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care populationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ea8c7c47-64a5-41ee-a3ee-4d645fdf5630EnglishSymplectic Elements at OxfordBioMed Central2006Wilson, SWakelam, MHobbs, RRyan, ADunn, JRedman, VPatrick, FColbourne, LMartin, AIsmail, T <p style="text-align:justify;"> <b>Background:</b> Bowel cancer is common and is a major cause of death. Meta-analysis of randomised controlled trials estimates that screening for colorectal cancer using faecal occult blood (FOB) test reduces mortality from colorectal cancer by 16%. However, FOB testing has a low positive predictive value, with associated unnecessary cost, risk and anxiety from subsequent investigation, and is unacceptable to a proportion of the target population. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with colorectal cancer, and this can be measured from a blood sample. Serum MMP-9 is potentially an accurate, low risk and cost-effective population screening tool. This study aims to evaluate the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population.<br/><br/> <b>Methods/Design:</b> People aged 50 to 69 years, who registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that asks about symptoms. Respondents who describe any colorectal symptoms (except only abdominal bloating and/or anal symptoms) and are prepared to provide a blood sample for MMP9 estimation and undergo a colonoscopy (current gold standard investigation) will be recruited at GP based clinics by a research nurse. Those unfit for colonoscopy will be excluded. Colonoscopies will be undertaken in dedicated research clinics. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the colonoscopy findings, and the combination of factors (e.g. symptoms and MMP-9 level) that best predict a diagnosis of malignancy (invasive disease or polyps) will be determined.<br/><br/> <b>Discussion:</b> Colorectal cancer is a major cause of morbidity and mortality. Most colorectal cancers arise from adenomas and there is a period for early detection by screening, but available tests have risks, are unacceptable to many, have high false positive rates or are expensive.<br/><br/> This study will establish the potential of serum MMP-9 as a screening test for colorectal cancer. If it is confirmed as accurate and acceptable, this serum marker has the potential to assist with reducing the morbidity and mortality from colorectal cancer. </p> |
| spellingShingle | Wilson, S Wakelam, M Hobbs, R Ryan, A Dunn, J Redman, V Patrick, F Colbourne, L Martin, A Ismail, T Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title | Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title_full | Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title_fullStr | Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title_full_unstemmed | Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title_short | Evaluation of the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population |
| title_sort | evaluation of the accuracy of serum mmp 9 as a test for colorectal cancer in a primary care population |
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