Episode 103. Fecal Occult Blood Test (FOBT) with Professor Finlay Macrae

Colorectal cancer is one of the most common cancers diagnosed in Australia with about 15,500 cases reported last year accounting for 10% of all new cancer diagnoses. Death from colorectal cancer at about 5300 yearly ranks only second behind lung cancer and accounts for about 10% of all cancer deaths in Australia highlighting the importance of its early detection and treatment.

Recognising these critical statistics the National Bowel Cancer Screening Program (NBCSP) was conceived and commenced in 2006 and by 2019 all Australians aged between 50 and 74 years were invited to participate in biennial faecal occult blood test screening for human haemoglobin using an immunochemical methodology as a surrogate marker of more serious internal colonic disease.

Although the current participation in the NBCSP is only a little more than 40%, the program is estimated to reduce the mortality rate from colorectal cancer by 15 to 25% and save about 1300 lives per year (more than deaths from road accidents annually). It is extremely important as clinicians that we support and promote this excellent screening initiative.

In this podcast, I was curious to learn how we may increase the national participation rate of this screening program as well as to review the performance characteristics of the immunochemical FOBT. I was also interested to review who should have an FOBT and who should not.

It was a real privilege to have a conversation with Professor Finlay Macrae on this important subject who is the head of colorectal medicine and genetics at the Royal Melbourne Hospital. Professor Macrae has public and private practices focusing on inflammatory bowel disease and familial bowel cancer. He trained both in Melbourne and at St Marks Hospital in London and has undertaken a significant body of clinical research in colon cancer prevention and detection. In 2016 he was awarded the Order of Australia for his work in genetics and genomics.

Professor Macrae has been close to the administration of the National bowel cancer screening program and remains on its clinical advisory group, he was, therefore, an obvious choice of the expert guest to discuss FOBT in the Australian context and it was a great privilege to have this conversation with him.

References:

Professorfinlaymacrae.com

National Bowel Cancer Screening Program, Australian Government: www.health.gov.au

Bowel Cancer in Australia statistics,www.canceraustralia.gov.au

To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au

Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.