Blood test for missing or damaged DNA could provide hint of a prostate cancer relapse

By Sophie Borland

A blood test for men with prostate cancer could detect if the illness is likely to be life-threatening, claim scientists.
At present it is extremely difficult for doctors to know whether a patient’s tumour is slow-growing - and harmless - or if it is deadly.
This means that thousands of men have to endure agonising surgery, chemotherapy or radiotherapy to remove tumours that may never have caused a problem.

Breakthrough: Researchers believe they've found a blood test that can determine the likelihood of prostate cancer returning

Now American scientists think they have come up with a method of predicting how quickly the tumour will spread.

 

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It could also determine whether the tumour is likely to return after surgery - which would warrant the patient having additional chemotherapy or radiotherapy.
The method involves testing the blood for a genetic abnormality - called the copy number variation, or CNV - that determines how quickly the cancer will spread.
Researchers at the University of Pittsburgh in the U.S, looked at the blood samples and records of 238 prostate cancer patients over a period of ten years.
They compared the levels of CNV with how the disease had progressed, as established from their medical records.

Hard cell: The method involves testing the blood for a genetic abnormality - called the copy number variation, or CNV

The academics found that in 69 per cent of patients the CNV blood test was able to correctly predict how quickly the tumour was growing.
In 81 per cent of cases it was able to determine whether it would return after treatment.
The scientists - whose work is published in the American Journal of Pathology - also tested patients’ tissue close to the tumours for levels of CNV and this showed similar success rates.
It is likely to be several years before the academics are able to develop a blood test to predict the speed prostate cancer will spread.
But lead researcher Dr Jian-Hua Luo, from the University of Pittsburgh School of Medicine, said in future it could prove to be ‘a more efficient and accurate way to predict the behaviour of prostate cancer.
‘For a patient diagnosed with prostate cancer, CNV analysis done on blood or normal tissues would eliminate the need for additional invasive procedures to decide a treatment mode.
‘For a patient already having a radical prostatectomy (surgery), CNV analysis on the tumour or blood sample may help to decide whether additional treatment is warranted to prevent relapse.’
New figures last week showed that 40,000 men are now being diagnosed with prostate cancer every year.
This increase is mainly due to greater use of the Prostate Specific Antigen (PSA) test, which measures levels of a chemical that is high when tumours are present.
But although the test has been credited with detecting some deadly cancer cases earlier, there are concerns it often causes ‘false alarms’.
And this month another group of American researchers claimed that surgery to remove prostate cancer is often ineffective.
A study involving 731 patients found that those who had operations were only 3 per cent more likely still to be alive 12 years later compared to those who didn’t have treatment.

Persistent cough 'could be warning sign of lung cancer': Stars who lost relatives to disease launch awareness campaign

By Claire Bates

Just one in 10 people realise that a persistent cough could be a key symptom of lung cancer, according to statistics released by the Government as it launches a campaign to raise awareness about the disease.
Despite the condition killing more people than any other form of cancer in England, very few people are aware a cough lasting three weeks is a sign of a potential sufferer.
An advertising drive backed by actor Ricky Gervais and TV presenter Jenny Frost will be launched tomorrow in a bid to raise awareness about the issue and improve earlier diagnosis in England.

Actor Ricky Gervais and singer Jenny Frost are both backing the Government's 'Be Clear on Cancer' campaign, after both lost a parent to lung cancer

It is hoped Be Clear on Cancer campaign will help save around 1,300 lives a year.
Health Minister Paul Burstow said: 'Lung cancer is the biggest cancer killer in this country but worryingly many people don't know the signs and symptoms that could save their lives.
'The earlier lung cancer is diagnosed, the better the chance of survival.
'The message from this campaign is simple; if you have a persistent cough for three weeks or more, visit your GP.'

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Lung cancer affects 33,000 people every year in England with the majority of cases occurring in people over the age of 55.
When diagnosed at its earliest stage, as many as 80 per cent of people are alive five years after diagnosis compared with only seven per cent diagnosed at a late stage.

Manchester United captain Sir Alex Ferguson lost both his mother and father to lung cancer, while Lynda Bellingham lost her sister

The campaign is being supported by a host of stars, many of whom have been touched personally by the disease. Manchester United captain Sir Alex Ferguson, 70, lost both parents to lung cancer.
He told the Manchester Evening News: 'My father was 66 when he died and my mother was only 64. Dad was diagnosed with lung cancer only a week after he retired and within 12 months it had killed him.
'Then my mum, who had smoked all her life, was diagnosed with lung cancer as well and she passed away a few years after my dad.'
Actor Ricky Gervais, who lost his mother to lung cancer when she was 74, said the condition was 'devastating'.
'It's a horrible, horrible disease,' he said.
Singer Jenny Frost cancelled her wedding in 2010 after her mother Rita succumbed to lung cancer.
Other celebrity supporters include actor Robert Powell, author Tony Parsons and actress Terry Dwyer who lost their fathers and Dragon Duncan Bannatyne who lost his mother. I'm A Celebrity star Stephanie Powers and writer Cassandra Jardine battled the disease themselves.

Campaign backers: Sir Alex Ferguson, Stephanie Powers, Tony Parsons and (bottom row) Linda Robson, Mark Lawrenson and Cassandra Jardine

The campaign follows an awareness-raising pilot in the Midlands in October last year. This showed improved knowledge of lung cancer and increased confidence in recognising the symptoms. There was a 23 per cent increase in attendance to primary care. Based on a sample of trusts, there was an increase in referrals for chest x rays and chest CT scans compared with the same period in the previous year.
Professor Sir Mike Richards, National Cancer Director for England, said: 'It is vital that cancer patients get treated quickly so they have the best chance of surviving. We have made early diagnosis central to our Cancer Outcomes Strategy.
'Earlier diagnosis of Lung Cancer combined with the best treatments could help save an additional 1,300 lives a year.'
Paula Chadwick, chief executive of the Roy Castle Lung Cancer Foundation, added: 'We really hope people will begin to associate a persistent cough as a symptom of lung cancer, the way they associate a lump as a symptom of breast or testicular cancer.'

Supporters: Ricky Gervais, Robert Powell, Nikesh Shukla, Lynda Bellingham with (bottom row left to right) Duncan Bannatyne,Tricia Penrose, Jenny Frost and Terri Dwyer

One in six cancers are caused by preventable infections

By Daily Mail Reporter

Two types of the human papilloma virus (HPV) cause around 70 per cent of all cervical cancers

One in six cancers are caused by preventable infections, research shows.
Infections cause around two million cancer cases a year, with 80 per cent of these effecting the developing world.

Of 7.5 million cancer deaths worldwide in 2008, 1.5 million were down to treatable or preventable infections, reports the Lancet Oncology.

Catherine de Martel and Martyn Plummer from the International Agency for Research on Cancer in France said: 'Infections with certain viruses, bacteria, and parasites are one of the biggest and preventable causes of cancer worldwide.

'Application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on future burden of cancer worldwide.'

For the study the team estimated the proportion of cancers that could be attributed to infection globally and in eight regions by calculating the population attributable fractions (PAF) - the proportion of new cancers in a population that could have been prevented by an intervention.

They calculated that around 16 per cent of all cancers worldwide in 2008 were infection-related, with the fraction of cancers related to infection about three times higher in developing than in developed countries.

The fraction of infection-related cancers varied widely between regions, from 3.3 per cent in Australia and New Zealand to 32.7 per cent in sub-Saharan Africa.

Dr de Martel said: 'Many infection-related cancers are preventable, particularly those associated with human papillomaviruses (HPV), Helicobacter pylori, and hepatitis B (HBV) and C viruses (HCV).'

Since September 2008 there has been a national programme to vaccinate girls aged 12 to 13 against the human papilloma virus

Cervical cancer accounted for around half of the infection-related burden of cancer in women, and in men liver and gastric cancers accounted for more than 80 per cent.

Dr de Martel concluded: 'The 2011 UN high-level meeting on non-communicable diseases highlighted the growing global agenda for prevention and control of non-communicable diseases.

'But although cancer is considered a major non-communicable disease, a sizable proportion of its causation is infectious and simple non-communicable disease paradigms will not be sufficient.'

In an accompanying Comment, Goodarz Danaei from Harvard School of Public Medicine, Boston, said: 'Their estimates show the potential for preventive and therapeutic programmes in less developed countries to significantly reduce the global burden of cancer and the vast disparities across regions and countries.

'Since effective and relatively low-cost vaccines for HPV and HBV are available, increasing coverage should be a priority for health systems in high-burden countries.'

Less Inflammatory Bowel Disease Seen in Southern Latitudes

Women living in the southern latitudes of the United States have significantly lower rates of Inflammatory Bowel Disease (IBD) than those living in the country's northern regions, according to new research published online January 11, 2012, in Gut.
Similar trends have been reported in Europe in the past; however, this is the first study to evaluate the role of latitude on IBD incidence in the United States.
To investigate the issue, Hamed Khalili, MD, from the Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, and colleagues evaluated data on 175,912 women enrolled in the Nurses' Health Study I (NHS) in 1976, and in the NHS II in 1989.
The data included information on the women's state of residence at birth, at age 15 years, and at age 30 years. The states were categorized as being in the northern, middle, or southern tiers of each of the 4 time zones (eastern, central, mountain, and pacific).
Follow-up data taken in 2003 identified 257 cases of Crohn's disease and 313 cases of ulcerative colitis among the women, with the incidence of each disease increasing significantly according to increased latitude (P _trend < .01).
The residence at age 30 years showed the strongest association with risk for Inflammatory Bowel Disease.
The multivariate-adjusted hazard ratio for women residing in southern latitudes compared with those residing at northern latitudes at age 30 years was 0.48 (95% confidence interval, 0.30 - 0.77) for Crohn's disease and 0.62 (95% confidence interval, 0.42 - 0.90) for ulcerative colitis. The multivariate analysis was adjusted for age, body mass index, ancestry (Southern European, Scandinavian, other white, nonwhite), smoking, and oral contraceptive and hormone therapy use.
"In two large prospective cohorts of US women, the incidence of [ulcerative colitis and Crohn's disease] was significantly lower among women who resided in the southern latitudes, particularly in later life (age 30 years), than in those residing in the northern latitudes," Dr. Khalili and colleagues write.
"These results were consistent even after accounting for differences in self-reported ancestry and smoking, suggesting that other environmental or lifestyle factors correlated with geographical variation may mediate these associations."
The authors hypothesize that the main explanation for the reductions in southern latitudes is related to greater levels of sun exposure and to the higher levels of plasma vitamin D that are associated with ultraviolet (UV) radiation.
"UV radiation is the greatest environmental determinant of plasma vitamin D and there is substantial experimental data supporting a role for vitamin D in the innate immunity and regulation of inflammatory response," the authors write.
"The role of vitamin D in the pathogenesis of IBD is further supported by the observation that animal models of colitis have more severe inflammation in vitamin D receptor knock out animals or animals deficient in 1,25(OH)₂ vitamin D."
In addition, UV radiation is associated with regulation of T cells, as well as the production of interleukin (IL) 4 and IL-10, and the inhibition of IL-12, which suppresses the inflammatory response, they note.
Bincy P. Abraham, MD, an assistant professor of medicine in the Inflammatory Bowel Disease Program at Baylor College of Medicine in Houston, Texas, said that vitamin D, or a lack thereof, has been recognized as a potential risk factor for IBD, but its role is not entirely understood.
"Theoretically, vitamin D can play a role in inflammation: low levels may contribute to inflammation, and thus can be explained by the general north–south gradient of inflammatory bowel disease we have seen historically in the US, as well as Europe," Dr. Abraham told Medscape Medical News.
"However, knowing the vitamin D levels in both groups of patients is important in order to clarify this," added Dr. Abraham, who was not involved in the study. "This is because there could be other confounders — other environmental causes that we do not know about."
In her own research on Inflammatory Bowel Disease, Dr. Abraham found high levels of abnormal bone density among patients with IBD and vitamin D deficiency, but that research was also inconclusive regarding the vitamin's influence.
"It was difficult for us to determine a correlation of IBD disease activity and vitamin D levels due to too many confounding variables," she said, noting that, among potential variables, there is even a theory that refrigeration of food may increase the risk for Inflammatory Bowel Disease.
"My general sense is that [a correlation with vitamin D] is quite possible," Dr. Abraham concludes. "We may need to do additional, larger-scale studies of vitamin D levels and their association in contributing to the development of Inflammatory Bowel Disease."
The study received support from the National Institutes of Health and the Broad Medical Research Program of the Broad Foundation. The authors included a clinical investigator for the Damon Runyon Cancer Research Foundation, and one author is supported by a career development award from the IBD Working Group and the Crohn's and Colitis Foundation of America. Dr. Abraham has disclosed no relevant financial relationships.

Fecal Calprotectin Helps Spot Pediatric Inflammatory Bowel Disease

By David Douglas
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."

Patients With IBD Fare Well on Their Travels

Patients with inflammatory bowel disease (IBD) who traveled to developed countries had a higher rate of illness compared with other travelers, but the rate of illness was the same for travel to developing or tropical regions. Most travel-related illnesses among the patients with IBD arose from sporadic flares of their disease, rather than increased susceptibility to enteric infections, suggested study authors Shomron Ben-Horin, MD, director of the IBD service, and coauthors from the Sheba Medical Center and Sackler School of Medicine of Tel-Aviv University in Tel Hashomer, Israel.
The research was published online November 3 and in the February print issue of Clinical Gastroenterology and Hepatology.
Compared with healthy control patients, the absolute increased risk for patients with IBD was small, and most episodes of illness that they experienced were mild, providing reassurance for many patients who want to travel.
Patients with IBD have often been advised to avoid travel, especially to developing countries, for fear of contracting infections or experiencing disease flares in regions with poor hygiene or potentially inadequate medical facilities. Self-imposed or physician-advised restrictions on travel can severely limit patients' quality of life or opportunities to do business abroad.
Because little data exist on the risk of travel for patients with Inflammatory Bowel Disease, the investigators performed a retrospective, case–control study comparing illnesses among patients with Inflammatory Bowel Disease (n = 222; 523 trips) and healthy control individuals (n = 224; 576 trips), using validated, structured questionnaires, interviews, and chart reviews. The questionnaires included items related to demographics, medical history (eg, travel clinic attendance, immunizations, and prophylactic and regular medications), details of all travel going back 5 years, and any illness during or within 3 months after any trips. The authors used the United Nations Human Developmental Index classification to identify developing and developed countries.
Individuals in the case group included individuals attending outpatient gastroenterology (GI) clinics at the medical center. Individuals in the control group included volunteers without known Inflammatory Bowel Disease who were drawn from hospital staff, their family members, and people escorting relatives undergoing endoscopies. The mean age of both groups was 37 years. Individuals in the control group received the same questionnaire as patients with IBD, but without IBD-specific items. The authors defined illness as any GI or non-GI episode.
Patients with Inflammatory Bowel Disease experienced illness in 15.1% of their trips compared with 10.9% of trips made by control patients (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.01 - 2.0; P = .04). For both patients with IBD and control participants, enteric disease accounted for 92% of the episodes, most of which were mild to moderate and resolved within a few days, the authors report. Only 5 patients with IBD and 4 control participants required hospital admission for any reason while traveling.
Travel to developed countries accounted for most of the difference in illness between patients with IBD and control participants. For the 2 groups, the rates of illness were the same when they went to developing regions (17% vs 21% of trips, respectively; P = .24).
Their rates of illness when traveling to developing countries (17% of trips) was not statistically different from when they went to developed countries (13.9% of trips; P = .32). They did, however, experience an almost 2-fold increased risk when traveling to the tropics compared with developed countries (OR, 1.9; 95% CI, 1.1 - 3.3; P = .02).
Control individuals experienced much less illness in developed countries (3.3% of trips) compared with travel in developing regions (21.4% of trips; OR, 6.6; 95% CI, 3.2 - 12.2; P < .001). When they went to the tropics, however, their rates of illness increased 10-fold compared with travel in developed countries (33.3% vs 3%, respectively; OR, 13.6%; 95% CI, 6.7 - 27.6; P < .001) and were not statistically different from the rate of illness for patients with IBD (P = .18).
Factors Influencing Travel-Related Risk
It appeared that underlying IBD activity was an important determinant of travel-related disease activity. Multivariate analysis showed that risk increased if patients experienced frequent flares (OR, 1.9; 95% CI, 1.1 - 3.4; P = .02) or had prior IBD-related hospitalizations (OR, 3.5; 95% CI, 1.3 - 9.3; P = .01). Among patients with IBD, disease remission for at least 3 months before traveling reduced the risk for travel-related illness by 70% (OR, 0.3; 95% CI, 0.16 - 0.5; P < .001). Patients in remission had the same risk for illness during travel as did individuals in the control group (12% vs 10.9%; P = .5).
In the multivariate analysis, there was no independent effect of the use of immunomodulatory drugs during the trip on the risk for illness during travel (P = .5).
Because the length of the trip may affect the likelihood of illness, the investigators normalized the results per 10 days of travel and found a 7% risk per 10 days for individuals in the case group vs 5% per 10 days for individuals in the control group (OR, 1.4; 95% CI, 1.01 - 1.96; P = .04). When stratified by trip duration, there was no increased risk for patients with IBD traveling to developing or tropic areas, in line with the nonnormalized analyses.
Travelers with IBD experienced disease flares within 3 months of returning to Israel after 16% of their trips. The incidence of flares was higher if travelers had experienced an episode of illness during the trip than for uneventful trips (43% vs 11.6%, respectively; OR, 7.4; 95% CI, 4.2 - 12.9; P < .001). The authors note that almost half of the patients with illness during the trip and flares afterward felt that the flare was a direct continuation of the episode during the trip.
The authors caution that the retrospective nature of the study makes it susceptible to recall bias, and they emphasize that it was not sufficiently powered to detect differences in rare opportunistic infections that may affect immunocompromised patients. They also warned that live attenuated vaccines such as those against yellow fever are contraindicated in such patients. Another limitation of the study is that it involved travelers from a single, developed country, and therefore the results may not be generalizable to travelers with IBD from other developed or developing countries.
Charles Ericsson, MD, professor of medicine, head of clinical infectious diseases, and director of the travel medicine clinic at the University of Texas Medical School at Houston; founding editor-in-chief of the Journal of Travel Medicine; and past-president of the International Society of Travel Medicine, told Medscape Medical News that the study is retrospective, albeit case-controlled, "so that immediately calls into question recall bias when you're asking people to remember trips up to 5 years later. I'm taking any of the data with a bit of a grain of salt." He said most of the illnesses were reportedly mild, but people tend especially to remember more severe illnesses.
"The data are OK as far as they go, but I think you're left with enough uncertainties that I will refuse to use data like this to say that I'm not going to worry about somebody with IBD when they travel to a developing country" and not offer them chemoprophylaxis against travelers' diarrhea, Dr. Ericsson said. Even if the incidence is not different from control participants, "when they do get travelers' diarrhea, I think the impact on the subject is profound because they don't know whether it's a flare of their IBD" that requires treatment or not, "and I'd rather prevent that conundrum to begin with." He admits he's "a fan of chemoprophylaxis" in general, offering rifaximin to his high-risk travelers, which is active in the upper GI tract, and therefore a good prophylactic agent.
Another issue "that does bug me a little bit is the outcome measurement [of] any illness," he said. He would have preferred the authors to distinguish enteric conditions from other types of illness. "They allude to the fact that...92% of the outcomes were enteric disease," he noted. "Then why not just study that 92%, to keep it clean? You would have a study that would have focused on the most important issue."
Dr. Ericsson also wondered about the meaning of the finding that the patients with IBD experienced more illness when they went to developed countries compared with control patients (P < .001), but not when they visited developing ones (P = .2). "What they didn't control for is the likelihood, I would think, that anybody traveling from a developed to another developed country may well not have been on a vacation but, rather, traveling for business, and was stressed out, and that's a known precipitator for a flare of your IBD," he noted. And he speculated that "the IBD people in fact are concerned about going to a developing country and take extra precautions," such as chemoprophylaxis or watching out for food and beverages.
The finding that people with IBD had such a high level of problems in developed countries, but not in developing ones, implies that they experienced only a very small level of travelers' diarrhea in developing countries. "It doesn't sit well with me," Dr. Ericsson said. "I'm not quite sure how to interpret it. I'm worried that there's confounding issues going on of behavioral differences that were not assessed."
Also, with a reported mean trip length of 22 days for both patients with IBD and control participants, he found the incidence of illness quite low compared with previous reports of travelers' diarrhea, depending on trip length. The specific countries, areas of the countries, and purposes of the trips may have affected the outcomes.
In summary, Dr. Ericsson said the study is valid as it is presented, but "it's the interpretation of it that has to be taken with a bit of a grain of salt." He said the findings may lead him to advise a patient with IBD who has had many flares to find out where to get treatment while traveling, as their risk for illness is increased.
He said that going forward, he would like to see a properly designed prospective case–control study implemented that looks at a sufficient number of patients with IBD as they travel, which may avoid some of the problems of recall bias during such a long period of a retrospective study as this one.
Dr. Ben-Horin has received consultancy fees from Schering-Plough and Abbott Laboratories. The other authors and Dr. Ericsson have disclosed no relevant financial relationships.

Fecal Calprotectin Helps Spot Pediatric IBD

By David Douglas
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."