A trial looking at the MMP9 blood test for people with symptoms of bowel cancer

Cancer type:

Bowel (colorectal) cancer





This trial looked at the MMP9 blood test to help doctors decide who should be referred urgently for tests for bowel cancer.

The symptoms of bowel cancer include a change in bowel habit, blood or mucus in the stools and weight loss. But conditions other than cancer can cause all these symptoms. Family doctors (GPs) have to decide who needs to be referred urgently for more tests, and who doesn’t.

Under the current referral guidelines for bowel cancer, as many as 94 out of every 100 people (94%) who are referred urgently don’t have anything seriously wrong with them. The research team hoped that a new blood test might help doctors decide who needs to be referred urgently. The test measures the amount of an enzyme Open a glossary item called MMP9. MMP9 stands for matrix metalloproteinase 9.

Early research had shown that the level of MMP9 was raised in people with bowel cancer or another medical condition that increases risk of developing bowel cancer, such as familial adenomatous polyposis (FAP), Lynch syndrome, ulcerative colitis and Crohn’s disease. They hoped that using the MMP9 test results alongside other medical information would mean that only patients who needed testing for cancer straight away would be referred urgently.

But before the test could be used in this way, we needed to know if it was reliable and accurate. The aim of this study was to find out if measuring MMP9 could help doctors decide which patients should have more tests urgently.

Summary of results

The study team found that testing for the MMP9 enzyme couldn’t help doctors decide which people they should refer urgently for possible bowel cancer.

This study recruited 1,002 people. Their GPs had sent them to the University Hospital Birmingham NHS Foundation Trust because they had symptoms of possible bowel cancer. Everyone had a blood sample taken to measure the amount of the MMP9 enzyme.

The study team then looked at

  • Each person’s symptoms
  • The amount of MMP9 in their blood
  • Their final diagnosis

They found that there wasn’t a link between the person’s symptoms, amount of MMP9 in their blood and their final diagnosis of bowel cancer or another condition.

The study team concluded that the amount of MMP9 enzyme in the blood was of little value when trying to decide who should be an urgent referral for a possible diagnosis of bowel cancer.  

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Sue Wilson

Supported by

National Institute for Health Research Cancer Research Network (NCRN)
University Hospital Birmingham Charities
University Hospital Birmingham NHS Foundation Trust

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle - 619

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Alan took part in a clinical trial for bowel cancer patients

A picture of ALan

“I think it’s essential that people keep signing up to these type of trials to push research forward.”

Last reviewed:

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