Blood tests are helping doctors spot diseases much earlier: Crohn’s disease is the latest example

Early diagnosis of inflammatory bowel diseases is vital to improve treatment outcomes, reduce surgery rates and improve quality of life for patients.

Some patients, however, already have established bowel damage by the time they are diagnosed – even though only a minority will have experienced symptoms for more than six months, highlighting a pre-clinical phase of the disease.

That’s according to a new paper published in the journal Cell Reports Medicine seeking to gain a better understanding of this phase.

Characterizing the pre-clinical phase of inflammatory bowel disease, it was found that inflammatory bowel diseases (IBDs) – Crohn’s disease and ulcerative colitis – may begin far earlier than previously thought. This could give doctors a considerable window of opportunity to intervene with lifestyle changes – such as to smoking or diet – or to treat people much earlier, the authors say.

IBDs have significant cost implications for healthcare systems and are on the rise globally – the Cell Reports Medicine paper states an 85% increase in patients between 1990 and 2017. Today, 10 million people worldwide live with IBD, according to the European Federation of Crohn's and Ulcerative Colitis Associations.

Adults with IBD are also more likely to have other chronic conditions – such as heart disease or diabetes – than adults without IDB, according to the US Centers for Disease Control and Prevention.

There is currently no cure for these chronic diseases and treatments often fail to stop the progression of disease, which can result in the need for life-changing surgery. As bowel damage can occur before symptoms appear, the researchers investigated whether blood changes could detect the disease.

Using an algorithm to help them analyze a vast Danish database of health records, they found that routine blood tests can detect signs of Crohn’s disease up to eight years before symptoms appear. In the case of ulcerative colitis, blood tests detected signs of disease up to three years before a diagnosis.

It is not known if these pre-clinical changes are specific to IBD. The authors, therefore, recommend further study into whether they could be a common feature among other inflammatory disorders.

The IBD paper joins a growing body of research into using blood tests to help doctors give earlier diagnoses of diseases and conditions.

In the UK, the National Health Service (NHS) is piloting a blood test to help detect cancer early. About 140,000 people aged 50 to 77 are participating in the trial, which the NHS says “could transform early cancer detection in England” if successful. It has described early results as promising.

Researchers are also looking at whether blood tests could help early diagnosis of neurodegenerative diseases, including Alzheimer’s and Parkinson’s disease. This could help doctors to intervene before irreparable brain damage occurs.

Research into diagnosing diseases earlier – or even predicting them – is important in a world where healthcare spending continues to outpace GDP growth on a global scale.

The World Economic Forum’s Global Health and Healthcare Strategic Outlook 2023 examines technology and innovation in health and healthcare systems with the goal of aligning stakeholders, industries and countries to a shared vision for health and healthcare by 2035.

One of its four main strategic pillars focuses on creating an environment that supports funding, use and implementation of innovation in science and medicine.

“We know there exists a strong potential for better and earlier diagnostics for treatment and prevention to improve patient outcomes,” says Dr Shyam Bishen, Head of the Centre for Health & Healthcare at the World Economic Forum. “Early blood tests are not just a diagnosis; they are a blueprint for proactive healthcare, unlocking the power to detect, prevent, and manage disease conditions before they take hold.

“Early diagnosis will not only save lives but will also improve system efficiency and reduce overall healthcare cost.”