Israeli researchers have developed a system to identify people at increased risk of colorectal cancer via a routine blood test.
The system was developed by researchers from the Maccabi health maintenance organization and the start-up Medial Research. They are now examining whether it could also be used to detect other types of cancer.
The Colonscore system (currently referred to as MeScore CRC on Medial’s website) is based on mathematical modeling. Its developers say it could detect hundreds of people with undiagnosed colon cancer every year.
Colon cancer is the second most common type of cancer in Israel among both men and women. Every year, some 4,000 Israelis are diagnosed with the disease, including about 1,000 who were diagnosed only when the cancer was already well advanced. This is critical, because if colon cancer is detected early, the recovery rate is very high.
The standard test for colon cancer today is the fecal occult blood test. If the results of that test are positive, the patient is then sent for an invasive colonoscopy. But many people don’t do the fecal occult blood test, resulting in the disease being discovered only when it’s already at an advanced stage.
The Colonscore system merely requires a regular blood count. The results are then subjected to mathematical analysis that identifies patients at risk of colon cancer.
To develop their model, the researchers, led by Prof. Varda Shalev of Maccabi, examined the blood counts of some 1,000 patients who had already been diagnosed with colon cancer to detect factors that were common to all the patients. Their findings were then published in the European Journal of Cancer Prevention.
“We discovered, for instance, that three and a half years before the disease was discovered, the patients’ blood counts already showed a decline in their hemoglobin levels,” Shalev said. “This is a decline that’s within the normal range, so it’s hard to identify it as a symptom that predicts the disease. But that’s just one variable from the huge amount of information found in blood tests.”
After completing their analysis of the blood counts, the Maccabi researchers contacted Medial, a start-up specializing in algorithmic analysis and developing complex mathematical models. Medial worked with the researchers to refine their findings and develop a model that would enable them to determine an individual’s risk of developing colon cancer.
Tested successfully on 1,000 patients
The model was then tested on the blood counts of 1,000 other patients, and it successfully detected those with colon cancer. It was also tested on a large medical database from Britain.
The results show that Colonscore’s accuracy in identifying colon cancer is similar to that of the fecal occult blood test. The system has been patented and is currently in the process of being approved by the U.S. Food and Drug Administration. It has already won approval from the European Union (the CE marking) and the Israeli Health Ministry.
Medial was founded about five years ago. Its development team includes doctors, mathematicians and graduates of the army’s elite signals intelligence unit, 8200.
CEO Ori Geva stressed that Colonscore requires only a single blood count. “This is a field that’s developing rapidly, and our model for colon cancer is the first in a series of different models for cancer that we’re working on,” he said.
Maccabi now plans to run the Colonscore test automatically on blood counts from any patient over age 50 who hasn’t done a fecal occult blood test in the last 18 months or a colonoscopy in the last 10 years. If the system detects a patient at increased risk of colon cancer, the patient will then be sent for a colonoscopy.
Current statistics show that colonoscopies detect precancerous growths in about 20 to 30 percent of patients, and cancerous growths in about 5 percent.
“Early detection of colon cancer is a challenge for health systems worldwide,” Shalev said, because “in its early stages of development, there are no symptoms that could warn the patient of any problem.”
“We still recommend a fecal occult blood test every year,” she added. “But there are patients who aren’t enthusiastic about doing the test, and the percentage of people who do so over time isn’t high.”
In contrast, she noted, most patients do routine blood counts “every year or two.”