You can do a lot to prevent colon and rectal cancer this year . . . and in the future.

Number One Resolution — Be screened for colorectal cancer if you are 50 or over, earlier if you are at higher risk.

In addition you can reduce your  colorectal cancer risk by:

• Exercising regularly.
• Keeping your weight normal.
• Eating less red meat, no processed meat at all, and mostly plant-based foods.
• Increasing the amount of fiber in your food.

Start on Monday, January 2, and review your progress toward better diet and exercise every Monday all year.  Research from leading public health schools for The Monday Campaigns shows that most people view Monday as a day for fresh starts.  They were most likely to begin exercising, start a diet, or stop smoking on Monday.

For the latest evidence on food, nutrition, and physical activity and their influence on colorectal cancer, read the World Cancer Research Fund’s Continuous Update Project focus on colorectal cancer.

Happy, healthy New Year!

A study in Boston randomly assigned community patient navigators to half of a diverse group of low-income patients who were behind in colorectal cancer screening.  Compared to patients who received usual health care, patients who got help from a patient navigator were more likely to complete screening, have a colonoscopy, and have polyps detected and removed.

After getting an introductory letter from their primary care doctor, patients in four community health centers and two public hospital clinics got a call from a patient navigator who spoke their language.  The navigator helped them decide how they wanted to be screened — with fecal occult blood testing or colonoscopy.

Patients spoke English, Haitian Creole, Portuguese, or Spanish as their primary language.

For the 465 patients in the study, patients assigned navigators were more likely to:

• Be screened for colorectal cancer within one year (33.6 % vs 20%).
• Be screened using colonoscopy (26.4% vs 13%).
• Have adenomas (polyps) detected (8.1% vs 3.9%).

Use of a patient navigator was particularly helpful for blacks and those who didn’t speak English as a their primary language:

• 39.7 % of blacks in the navigator group were screened compared to 18.6 % in the usual care group.
• 39.8 % of non-English speakers helped by navigators got screened compared to 16.7 % who didn’t have a navigator.

The patient navigators were lay people in the community who guided patients through the medical and screening system, answering questions, helping them to get insurance, and arranging transportation and childcare.  They were able to reach 7 out of 100 patients assigned to the program and contacted each individual a median of 8.5 times, spending an average of 107 minutes with each patient.

In a commentary, Thomas Bodenheimer, MD, of the University of California San Francisco, observed that the intervention worked because physicians had help from a team.  He said,

In this era of primary-care-physician shortage and excessive panel sizes [numbers of patients per physician], quality improvement requires reducing panel size or delegating responsibilities from the physician to a healthcare team.

Writing in the Archives of Internal Medicine, Karen E. Lasser, MD, MPH and her colleagues concluded,

Patient navigation increased completion of CRC screening among ethnically diverse patients. Targeting patient navigation to black and non–English-speaking patients may be a useful approach to reducing disparities in CRC screening.

SOURCE: Lasser et al., Archives of Internal Medicine, Volume 171, Number 10, May 23, 2011. doi:10.1001/archinternmed.2011.201

However, almost half of Medicare patients with a negative colonoscopy got another exam within 7 years, and for one in four there was no clear evidence that they needed one.

Because colonoscopies have real risks and are expensive, over-testing can be both dangerous and costly. Given limited numbers of physicians who do colonoscopies, unecessary procedures add to long waiting lists for screening and for necessary follow-up exams.

Although Medicare regulations call for reimbursement only after 10 years in cases where the first procedure didn’t find a problem, payments are being made for earlier exams.  In fact, Medicare denied payment for only 2 percent of colonoscopies for which there was no clear indication of need.

Researchers at the University of Texas in Galveston reviewed a representative sample of Medicare claims for a  colonoscopy between 2001 and 2003.  Since they were looking for average risk patients who had a negative screening colonoscopy, they filtered out any tests that included removing a polyp or a biopsy or other procedure done during the exam.  They also removed any colonoscopies that included a diagnosis such as bleeding or pain and any that were done for patients who had a Medicare claim in the previous 3 months that included a diagnosis or symptoms of colorectal disease that might have indicated need for a  diagnostic colonoscopy.

In their sample of 5% of the Medicare population:

• 236,145 Medicare patients 66 and older had a colonoscopy in 2001-2003.
• 114,468 had an negative exam with no polyps removed, no biopsies or other procedure.
• 24,071 had a negative screening colonoscopy after all possible medical reasons for doing the test were eliminated.

The research team then looked for repeated colonoscopies within 5 and 7 years of the first test.  Again they eliminated any exams for which a diagnosis or other Medicare claims indicated a good reason to repeat the test.  If they couldn’t find a reason, they classified the colonoscopy as repeated with no clear indication.

In their sample of 24,071 who had a completely negative screening colonoscopy between 2001 and 2003,  8,608 had another colonoscopy within 7 years, and for 3,656 no reason other than routine screening could be found for doing the test.

However, only 86 patients (2 percent) actually had payment denied by Medicare.

Although the US Preventive Services Task Force recommends against routine screening for people between age 75 and 84 and against any screening for those over 85, one third of patients who were 80 or older at their initial negative screening colonoscopy had another exam within 7 years.

The study authors pointed out,

This is of special concern, given the increased potential for complications and decreased benefit of this examination in the very old.

Repeating a colonoscopy early after a negative exam was more likely to occur when:

• Endoscopist doing the first colonoscopy did more than 1,200 procedures a year.
• Exam took place in a doctor’s office rather than hospital or ambulatory surgical center.
• Patients were male.
• Exam took place in the Middle Atlantic or North Central regions of the United States.
• Patients had less than a high school education.

For average risk patients without a family history of inherited colorectal cancer, the natural development of cancer from even quite large polyps is slow.  Before the era of colonoscopy, doctors at the Mayo Clinic followed 226 patients who had barium enemas with advanced adenomas (over 1 cm) for 5, 10, and even 20 years.  During that time only 2.5% became cancer at 5 years and 8% at 10 years.  Seven out of ten cancers were found at an early stage before spreading to lymph nodes or distant sites.

After analyzing their results, James Goodwin, MD, and his colleagues at the University of Texas concluded,

A large proportion of Medicare patients who undergo screening colonoscopy do so more frequently than recommended. Current Medicare regulations intending to limit reimbursement for screening colonoscopy to every 10 years would not appear to be effective.

SOURCE:  Goodman et al., Archives of Internal Medicine, online first May 9, 2011.

What This Means for Patients

Although the research was done in Medicare patients over 65, there is no reason to believe that younger patients are not also being screened more often than guidelines call for for.

• After your screening colonoscopy, be sure that you have a copy of the the results that describe if adenomas (polyps) were found and what their size and description was. If you don’t understand the report, ask your doctor to explain it.
• Check to see if the recommendation for the next screening exam fits within the guidelines for colorectal cancer screening.  If the return recommendation is sooner that guidelines call for, ask why!

For people at average risk of colorectal cancer, colonoscopy screening is recommended beginning at age 50 and then every 10 years unless adenomas or cancer are found.

The US Preventive Services Task Force says that elderly people between 75 and 84 should not be routinely screened for colorectal cancer and those over 85 should not be screened at all.  If your older relative is getting colonoscopy recommendation that don’t fit the guidelines, ask why. They are at higher risk for complications from the procedure and may well not benefit from screening.

But remember:

• Symptoms of colorectal cancer at any time – even after a negative screening colonoscopy — and at any age call for diagnostic colonoscopy.
• People with a family history of colorectal cancer or a personal medical history of cancer, adenomas, or inflammatory bowel disease (ulcerative colitis or Crohn’s disease) are not at average risk. They should follow screening and surveillance programs for increased and high risk, including beginning earlier than 50 and being screened more often.

The latest statistics, just reported by the federal Agency for Healthcare Research and Quality on March 23, found that:

• In 2008, among adults aged 50 or over, about 60 percent of whites reported ever having been screened (up from 51 percent in 2000);
• About 55 percent of blacks and Asian Americans had been screened at least once (compared to 44 percent in 2000);
• In the same age group, only 44 percent of Hispanics reported ever having been screened (slightly increased from just 35 percent in 2000), even though this population has the third-highest death rate from colorectal cancer;
• Screening rates actually decreased among American Indians and Alaska Natives, to only 37 percent in 2008 (compared to 41 percent in 2000).

Among people without health insurance, screening rates were significantly lower in all ethnic groups:

• Among both whites and blacks with no health insurance, the at-least-once screening rate was about 30 percent (increased barely from 26% in 2000);
• Screening worsened to an abysmal 13 percent (down from 16 percent in 2000) among Hispanics with no health insurance.

In summary, even among those with insurance, only half—and often far fewer—people over age 50 are getting even one screening. Among the uninsured, screening is just not being done for a cancer that can be prevented or cured if caught early.

Source: Agency for Healthcare Research and Quality, 2010 National Healthcare Quality and Disparities Reports

Australia has one of the highest colorectal cancer (CRC) mortality rates in the world. Its current screening program (costing about $29 million a year) provides a one-time immunochemical fecal test (iFOBT) for people aged 50, 55, and 65 years. Program funding expires in mid-2011.

A study funded by the Australian government and the US National Cancer Institute, published in the Feb. 21 Medical Journal of Australia, found that expanding the program to screen all 5 million Australians aged 50 -74 years every two years by iFOBT could end up costing only about $50 million more a year, while saving 300 to 500 lives every year.

“…Expanding the National Bowel Cancer Screening Program is the best investment available to the Australian Government for reducing cancer deaths in the short and long term,” said Professor Ian Olver, CEO of the Cancer Council Australia. He noted that the estimated gross cost, $150 million (including $97 million for follow-up and surveillance colonoscopies), was comparable to existing breast and cervical screening programs. “Yet bowel cancer is killing 1,200 more Australians each year than breast and cervical cancers combined,” Olver said.

Moreover, the expanded screening program would actually end up costing the government only about $80 million a year, study authors estimated, due to fewer CRC cases and lower treatment costs with earlier diagnosis.

Lead author Professor Mike Pignone, University of North Carolina, said “The health system in Australia is well-regarded internationally, so it’s anomalous that such a beneficial program, in terms of both health outcomes and cost-effectiveness, faces an uncertain future.”

This Wednesday and Thursday, March 2nd and 3rd, take five minutes to help us get legislation passed that would create a national screening program in the US. Join the Congressional Butt-in, a phone blitz to Congress!

Sources: Medical Journal of Australia 2011:194 (4) 180-185; Cancer Council of Australia

By 2008 almost 2 of every 3 Americans over the age of 50 had either had a fecal occult blood test in the past year or sigmoidoscopy or colonoscopy within the past ten years.

Health insurance made a huge different with two-thirds (66.6 percent) of people with insurance up-to-date with screening compared to about one-third (37.5 percent) of those without health insurance.

From 2002 through 2008, screening rates for people with health insurance went up almost 11 percentage points, while rates for the uninsured went up less than 5 percent.

Rates also lagged for the poor, for those without a high school education, and Hispanics.

States with the highest rates included New Hampshire, Utah, and Connecticut while Mississippi, Louisiana, and New Mexico had the lowest.

People who were 65 and older were much more likely to have been screened than younger adults — 72.8 percent compared to 58.2 percent for those from 50 to 64.

Overall screening rates were:

• 53.8 percent in 2002
• 60.7 percent in 2006
• 64.2 percent in 2008

Information for the Centers for Disease Control analysis comes from the 2002, 2004, 2006, and 2008 Behavioral Risk Factor Surveillance System (BRFSS) surveys.  The BRFSS surveys come from randomly dialed telephone calls to people in the United States over the age of 15.  About half of calls made reached someone, and three out of four of those reached were willing to answer the survey questions.  In 2008, 250,000 people were surveyed.

SOURCE: Centers for Disease Control, Morbidity and Mortality Weekly Report, January 14, 2011

Doctors can use a simple set of screening questions available online to pinpoint an individual’s risk before that person ever gets cancer.   The online tool takes less than two minutes to complete.

If family history shows an individual to be at higher risk, genetic testing not only saves lives but is cost-effective.

Once Lynch syndrome is diagnosed, active steps can be taken to prevent Lynch-associated cancers or diagnose them early when they can be cured.

A team at the University of Michigan used an Archimedes computer stimulation to model how questioning individuals without cancer about family cancer patterns would affect development of colorectal and uterine cancer.   They put information for a theoretical 100,000 people into their model, including how many people would actually get screened, what cancer outcomes are, and what costs would be.

They found that if screening questions were asked between the ages of 25 and 35 and people who had more than a 5 percent risk of Lynch syndrome based on those questions got genetic testing, their chance of getting colorectal were reduced by more than 12 percent.  Risk of uterine cancer went down by nearly 9 percent.

The cost per quality-adjusted life year (QALY) was $26,000 — well within the range of other preventive screening programs for colorectal, cervical, and breast cancer.  Usually a QALY below $50,000 is considered cost-effective.

Clues that someone might be at risk for Lynch syndrome include

• A family history that includes colon or uterine cancer.
• Family members whose cancers were diagnosed at a young age — below the age of 40 to 50.
• Patterns of of several cancers in the family or in one person.

The cost to genetically test one person, identified by screening questions at risk for Lynch syndrome, is about $2,600.  Once the family mutation is discovered, testing additional family members is much less expensive — about $300.

During an American Association for Cancer Research press conference to discuss the study, Dr. Henry Lynch, professor of medicine and director of the Hereditary Cancer Center at Creighton University School of Medicine in Omaha, Nebraska, who discovered Lynch Syndrome, said,

I first presented this hereditary concept in 1964, and since then it has become more accepted. However, cost has always been a hurdle. With this new information about cost, we’ll be able to save a lot of lives and as a medical oncologist I feel very good about that.

Heather Hampel, genetic counselor at the Ohio State University pointed out that 1 in 35 patients with colorectal cancer has Lynch syndrome which translates to 1 in 370 Americans who carry a mutated gene for it. It is one of the most common inherited cancers.  Hampel has been instrumental in promoting another way of identifying people at risk by screening tumors from all people with colorectal cancer for MSI (microsatellite instability).  Patients with MSI then get full testing for gene mutations that cause Lynch syndrome.  While effective, she says that this strategy in not uniformly carried out.  It also requires having someone actually get cancer before family risk can be determined.

You can listen to Dr. Lynch, Ms. Hampel and other Lynch syndrome experts discuss the study and its impact during the press teleconference on the American Association for Cancer Research site.

Dr. Judy Garber, AACR President-elect, observed that Lynch syndrome is twice as frequent as BRCA breast cancer mutations, yet is much less often recognized.  She said the implications of the new study were huge.

This will affect a wide population by changing our thinking about risk for colon cancer. Young individuals will be able to have an assessment of their personal and family history using a computerized model that can help guide their colon cancer risk management for decades, and make it possible to prevent significant numbers of colon and associated cancers, especially in young people, for a very reasonable cost. It is a huge step forward in terms of bringing the benefits of cancer genetics to the broader population using tests that have, in the past, been considered too expensive.

Tuan A. Dinh, Ph.D., head of cancer modeling at Archimedes Inc., and lead researcher Stephen Gruber, M.D., Ph.D., M.P.H., director for cancer prevention and control at the University of Michigan Comprehensive Cancer Center, wrote,

These results suggest that primary screening of individuals for mismatch repair gene mutations, starting with risk assessment between the ages of 25 and 35, followed by genetic testing of those whose risk exceeds 5%, is a strategy that could improve health outcomes in a cost-effective manner relative to current practice.

SOURCE: Dinh et al, Cancer Prevention Research, published online November 18, 2010.

What This Means for Patients

Even if you do not have colon or rectal cancer, you can ask your doctor to estimate your risk for carrying one of the mutated genes that causes it.

A simple questionnaire is available online.

If your risk after completing the questionnaire is more than 5 percent, genetic testing can tell you and your family more whether you carry a genetic mutation that causes Lynch syndrome.  If you do have a mutation, close family members can also be tested.

While the cost of identifying the first family member is high — an average of $2,600 — additional members only need testing for one gene at an average cost of about $300.

Some people are concerned that being identified with Lynch syndrome or other inherited conditions will keep them from getting health insurance.  They also worry about job discrimination. GINA (the Genetic Information Nondiscrimination Act) protects them from being denied health insurance or charged more for it based on family history or genetic tests.  It also prohibits employers from refusing to hire someone with an inherited condition or treating them differently during their employment.

If you find out that you do have a mutation linked to Lynch syndrome, you can take steps to protect yourself against getting cancer or dying from it including:

• Annual colonoscopies beginning at age 20 to find polyps and remove them.
• Regular gynecological exams, including uterine biopsies and ovarian cancer screening, beginning at age 30-35.
• Removal of uterus and ovaries once childbearing is over.
• Depending on family history, regular upper endoscopies to find stomach cancers early.

Awareness Saves Lives.

The computer model looked at 100,000 average risk people and compared screening methods results for

• number of colorectal cancer cases
• number of colorectal cancer deaths
• cost of screening and treating colorectal cancer for each screened person

Compared to not screening at all, annual FIT  could save 3 out of 4 deaths from colorectal cancer. For every 100,000 people between 50 and 75, nearly 3,500 people wouldn’t get colorectal cancer, and over 1,300 wouldn’t die.

Not only did FIT screening save the most lives, it was the most cost effective.  It saved about $70 (Canadian) in screening and cancer treatment expenses for each person screened, better than any other method.

FIT vs Colonoscopy

Steven Heitman,of the University of Calgary in Alberta and and his team found

• If no one was screened at all, there would be 4,857 cases of colon or rectal cancer and 1,782 deaths over the lifetime of every 100,000 people in North America.
• Annual testing with FIT reduced cases of colorectal cancer to 1,393 and deaths to 457.
• Colonoscopy done every ten years, with follow-up exams every 3 to 5 years when polyps were found, would reduce cases to 1,825 and deaths to 624.

While FIT was more effective than colonoscopy, it needed to be done every year, while colonoscopy screening is recommended every ten years.  The researchers  wrote,

Although it may seem counterintuitive that screening with FIT could be even more effective than colonoscopy, this is due to the more frequent screening interval with FIT.

The computer assumed that patients would adhere to a program of annual testing with follow-up colonoscopy for positive testing 63 percent of the time.  When adherence fell below 40 percent, colonoscopy became a better option.

Healthcare Costs of Screening and Cancer Treatment

In considering health care costs, the research team included the cost of screening itself, follow-up colonoscopy when required, treating bleeding or perforation complications of colonoscopy or CT colonography, and the cost of recommended surgery and chemotherapy for each stage of cancer.  They also included expenses for time and travel for patients and caregivers.  All costs were reported in 2008 Canadian dollars.

All methods included in the model were considered to be done at the recommended intervals, with appropriate follow-up.  .

Per person screened, the cost of screening and recommended cancer treatment, including biologics for stage IV cancer:

• FIT –$1,833
• No screening — $1,901
• High sensitivity FOBT — $2,084
• Colonoscopy — $2,100
• Low sensitivity FOBT — $2,192
• Flexible sigmoidoscopy — $2,263
• CT colonography– $2,409
• Fecal DNA test (2nd standard) — $2,491
• Fecal DNA (first standard) — $2,720

FIT vs Other Screening Methods

A fecal immunchemical test with mid-level sensitivity was more effective than any other screening method overall.  A higher sensitivity FIT reduced cancers and cancer deaths, but cost more.  A low sensitivity test, with only one sample, was less effective overall — costing more and reducing fewer cases and deaths.

In conclusion, Steven J. Heitman and colleagues at the University of Calgary in Alberta, wrote,

CRC screening with FIT reduces the risk of CRC and CRC-related deaths, and lowers health care costs in comparison to no screening and to other existing screening strategies. Health policy decision makers should consider prioritizing funding for CRC screening using FIT.

Although FIT proved the best at preventing new cancers and cancer deaths, all the screening methods studied were better than no screening at all.

Colorectal cancer screening saves lives!

The American Cancer Society has an excellent review of the current screening guidelines with detailed descriptions of each of the screening methods that were modeled.

SOURCE:  Heitman et al., PLoS Medicine, November 23, 2010.  An Open Access article from the Public Library of Medicine.

What Does This Mean for Patients?

This study offers more information about effective ways of screening for colorectal cancer.

Although you may have considered colonoscopy the “gold standard”,  this research demonstrates that for a large group of people, annual FIT testing actually prevents more cases of cancer and saves more lives.

If the risks of colonoscopy screening concern you, choosing FIT might be a choice for you.  If you do you need to be sure:

• You are willing to do the test every year.
• You realize that a positive test needs colonoscopy follow-up and you are willing to do that.
• Your doctor explains the sensitivity of the different FIT tests and you are given one that has mid to high level sensitivity.
• You get clear instructions for completing the test at home and mailing it back.
• You are an average risk person with no family or personal risks for colorectal cancer.

FIT might also be an affordable choice for people without insurance — although if positive, colonoscopy is necessary.

FIT is a different fecal test than the more commonly used FOBT — fecal occult blood test.  In the computer model, FOBT screening prevented the fewest cancers and saved the fewest lives except for the earlier version of fecal DNA testing.  Be sure that the test you are getting is a fecal immunochemical test.

* Incidence rates of late-stage colorectal cancer increased with age and were highest among black men and women.
* Late-stage colon and rectum incidence rates ranged from 51.0 to 86.5, and were highest in Connecticut, Delaware, Illinois, Iowa, Kentucky, Louisiana, Maine, Nebraska, New Jersey, and Pennsylvania.

“This report causes concern because so many preventable cancers are not being diagnosed when treatment is most effective,” said Marcus Plescia, MD, MPH, Director, Division of Cancer Prevention and Control. “More work is needed to widely implement evidence-based cancer screening tests which may lead to early detection and, ultimately, an increase in the number of lives saved.”

The CDC report is the first to highlight the nationwide incidence of late-stage cancer diagnosis and cancer screening prevalence, the incidence rates of late-stage cancers differed by age, race/ethnicity, and state.

The CDC’s Colorectal Cancer Control Program currently funds colorectal cancer screening programs in 25 states and 4 tribal organizations. However, we need your help to make this program permanent! In order to expand the CDC’s Colorectal Cancer Control Program nation-wide and allow the CDC to cover treatment costs we need to get Representative Kay Granger’s “Colorectal Cancer Early Detection, Prevention and Treatment Act” enacted into law. If you haven’t already done so, please take a minute to call your Representative and ask them to cosponsor H.R. 1189.

How to Call Your Representative
* Dial the Capitol Switchboard at 202-224-3121 and ask to be connected to your Representative (you’ll need to know your Rep’s name).
* Once you are connected to your Representative’s office, identify yourself as a constituent.
* Leave a message asking your Representative “to cosponsor H.R. 1189 to save thousands of lives and save Medicare billions.”

Want to help increase awareness of the importance of early detection and screening in your city and state? Download our Proclamations 101 toolkit and request a proclamation recognizing March as Colorectal Cancer Awareness Month from your city council, mayor, and/or governor. Our toolkit includes sample letters to the editor and press releases you can use to get the word out about the importance of early detection and screening. The toolkit and more information is available online at http://link.fightcrc.org/proclamations101.

There may be an answer for them in an improved stool test that looks for DNA that is changed in both colorectal cancer and some precancerous polyps.

Of course, if the stool test identifies possible polyps or cancer, a colonoscopy is critical to evaluate the findings and remove polyps.

The test that looks for methylated DNA in human feces, found 85 percent of cancers and 64 percent of large adenomas.  There were few false positives.  Only one in ten follow-up colonoscopies didn’t confirm cancer or adenomas.

Reported at the AACR Colorectal Cancer: Biology to Therapy conference in Philadelphia in October, the screening test was validated in 1,100 patients.

DNA methylation is a chemical change that plays a crucial role in the development of almost all cancers, including colon and rectal cancer.   Methylation can change the way cells grow out of control and develop into cancer. Cells with the altered DNA are shed constantly from the colon wall and from polyps into stool and passed during bowel movements.

Sensitivity

The test was most sensitive for early cancers, which are potentially curable, finding 87 percent of stages I through III.  Strangely, it only found 69 percent of stage IV colorectal cancers,a loss DNA methylation which the scientists can’t explain.

As adenomas grow, the test become more sensitive.  It only finds 31 percent of polyps under 1 centimeter, but 64 percent of those over a centimeter, 79 percent of polyps bigger than 2 cm, and 91 percent of adenomas larger than 3 cm.

Sensile or flat polyps were also detected.

It was equally effective in finding both polyps and cancers in the upper and lower parts of the colon — a problem for colonoscopy, which may miss polyps in the upper or proximal colon.  Age or gender didn’t make a difference.

Patient-friendly

Dr. David Ahlquist pointed out the value of the stool DNA screening test.

There is definitely an incentive and legitimate justification to be designing a screening approach that is user friendly, affordable and has the ability to detect pre-cancers. The noninvasive stool DNA test we have developed is simple for patients, involves no diet or medication restriction, no unpleasant bowel preparation, and no lost work time, as it can be done from home. Positive tests results would be followed up with colonoscopy.

How About Now?

The new test, being developed by Exact Sciences, is simpler than earlier stool DNA testing both for patient and for the testing system.  The faster, simpler test may be less expensive when it is on the market.

But, for now, the test remains experimental.  A large clinical trial, involving at least 8,000 people will begin early next year, which may lead to FDA approval for screening use in the United States.

During the discussion at AACR conference, Ahlquist was asked what doctors should do if patients read about the new screening test and ask for it.  He replied that it is not yet ready for the general public and that patients should be encouraged to have a colonoscopy now.

Learn More

A video from Exact Sciences provides additional information about how the stool DNA test works.