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The challenge

A more sensitive test for colorectal cancer recurrence

Bowel cancer, also known as colorectal cancer (CRC), is the second most common cause of death from cancer in Australia, with almost 15,000 new cases diagnosed and 4,000 deaths annually.

Post-surgical recurrence of CRC occurs in 30 to 50 per cent of cases, most often in the first two to three years of initial diagnosis and treatment. Current monitoring of recurrence is via a blood test for carcinoembryonic antigen (CEA), a well-described marker for gastrointestinal tract diseases, especially CRC, in combination with CT scans and other clinical assessments. CEA has low sensitivity and is subject to false-positive results, limiting usefulness.

Our response

A science and industry partnership to develop a better test for CRC

CSIRO, in collaboration with Flinders University and Australian-founded biotechnology company Clinical Genomics, identified DNA with cancer-specific chemical changes associated with bowel cancer which are not found in normal colon tissue. The team was able to show that some of these changes can be detected in the blood of patients with CRC, providing a reliable marker for detection of the disease.

This discovery was used to develop a new innovation, known as Colvera™, a blood test which detects these cancer-specific chemical changes in fragments of DNA from the tumour found circulating in the blood. Clinical trials have shown Colvera™ to be more than twice as sensitive for CRC recurrence as the current CEA test.

Clinical Genomics successfully launched Colvera™ in the US market in 2017. The test is currently available in the US through Clinical Genomics' laboratory in Bridgewater, New Jersey.

The results

Improved health outcomes

The impact

Colvera™ improves health outcomes by following a proven test/treatment pathway. The assay has been shown to identify a significantly greater number of patients with recurrence than the current guidelines-recommended non-invasive blood test, CEA. This technology is assumed to result in an increased rate of therapy with curative intent and improve overall survival.

Looking at a range of impacts, our estimates suggest that the program expenditure of $12.6 million (in real, present value terms) will lead to:

  • Total benefits for CRC recurrence monitoring (measured as reduced health system costs and improved patient health outcomes in Australia, in real, present value terms) between $94.3 million and $325.7 million over the next 10 years, depending on the assumptions made
  • A benefit cost ratio between 7.2:1 and 30.5:1.

Download the impact evaluation report:

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