As part of the regional Prevention Serena program, the first study on the personalization of colorectal cancer screening is active: the BIOFIT project, coordinated by the CPO with the collaboration of the Italian Institute for Genomic Medicine of Turin and the Edo and Elvo Tempia Fund of Biella, will involve The research will be the City of Turin and the ASL TO3, TO5, Alessandria and Biella.

The transition from a "one size fits all" to a "tailor-made" screening promises to increase the ability to prevent invasive cancers in subjects characterized by a high risk and at the same time to reduce the negative effects of screening in those who are at low risk. risk.

Personalized screening can be evaluated in the presence of a sufficient body of knowledge to identify risk factors for cancer and validated methods for risk stratification in the target population.

The cumulative value of fecal hemoglobin levels from two consecutive screening tests has proven effective in identifying high- and low-risk subjects. Furthermore, biomarkers, if validated for their predictive value for cancer risk, could represent an alternative or a complementary approach to the tests in use, offering further information to define the risk level of subgroups of the population invited for screening.

Finally, an association between lifestyle (diet, exercise, smoking) and cancer risk is widely documented. The combined analysis of lifestyle risk factors and the expression levels of fecal biomarkers could contribute to greater accuracy in risk definition.

BIOFIT is divided into two parts:

  • RCT testing risk-modulated screening intervals defined by the cumulative value of fecal hemoglobin relative to the last two screening tests;
  • case-control study nested in the trial, to study the correlation between lifestyle factors and biomarkers (such as miRNAs and the microbiome) with the onset of colorectal cancer.

If this study and similar ones confirm the non-inferiority or superiority of personalized screening compared to standard screening, the introduction of risk-based protocols could make screening more accurate, targeted, effective and efficient.

To find out more about BIOFIT: