Ryan, Angela V., Wilson, Sue, Dr, Wakelam, Michael J. O., Warmington, Sally A., Dunn, Janet A., Hodgkin, Richard F. D., Martin, Ashley and Ismail, Tariq (2006) A prospective study to assess the value of MMP-9 in improving the appropriateness of urgent referrals for colorectal cancer. BMC Cancer, Vol.6 (No.251). doi:10.1186/1471-2407-6-251 ISSN 1471-2407.

Preview

PDF WRAP_Dunn_Prospective_study.pdf - Requires a PDF viewer. Download (238Kb)

Request Changes to record.

Abstract

Background
Bowel cancer is common and is a major cause of death. Most people with bowel symptoms who meet the criteria for urgent referral to secondary care will not be found to have bowel cancer, and some people who are found to have cancer will have been referred routinely rather than urgently. If general practitioners could better identify people who were likely to have bowel cancer or conditions that may lead to bowel cancer, the pressure on hospital clinics may be reduced, enabling these patients to be seen more quickly. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with such conditions, and this can be measured from a blood sample. This study aims to find out whether measuring MMP-9 levels could improve the appropriateness of urgent referrals for patients with bowel symptoms.

Methods
People aged 18 years or older referred to a colorectal clinic will be asked to complete a questionnaire about symptoms, recent injuries or chronic illnesses (these can increase the level of matrix metalloproteinases) and family history of bowel cancer. A blood sample will be taken from people who consent to take part to assess MMP-9 levels, and the results of examination at the clinic and/or investigations arising from the clinic visit will be collected from hospital records. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the resulting diagnosis. 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.

Discussion
Although guidelines are in place to facilitate referrals to colorectal clinics, symptoms alone do not adequately distinguish people with malignancy from people with benign conditions. This study will establish whether MMP-9 could assist this process. If this were the case, measurement of MMP-9 levels could be used by general practitioners to assist in the identification of people who were most likely to have bowel cancer or conditions that may lead to bowel cancer, and who should, therefore, be referred most urgently to secondary care

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Intestines -- Diseases, Cancer -- Diagnosis
Journal or Publication Title:	BMC Cancer
Publisher:	BioMed Central Ltd.
ISSN:	1471-2407
Official Date:	23 October 2006
Dates:	Date Event 23 October 2006 Published
Volume:	Vol.6
Number:	No.251
DOI:	10.1186/1471-2407-6-251
Status:	Peer Reviewed
Access rights to Published version:	Open Access (Creative Commons)
Funder:	University Hospital Birmingham Charities, Midlands Research Practices Consortium (MidReC), Wellcome Trust (London, England), Great Britain. Dept. of Health (DoH), NHS Research and Development

Data sourced from Thomson Reuters' Web of Knowledge

Request changes or add full text files to a record

Repository staff actions (login required)

View Item

Downloads