Tag Archives: FOBT

FDA approves first non-invasive DNA test for colorectal cancer

Big news in the colorectal cancer prevention and screening community yesterday! In a never-before-seen move, the Food & Drug Administration (FDA) and Centers for Medicare & Medicaid Services (CMS) jointly proposed Cologuard as a new option for colorectal cancer screening. What is Cologuard? Cologuard, produced by Exact Sciences, is a non-invasive (not requiring insertion of instruments into the body), stool-based (you test your poo) DNA test designed to analyze the presence of blood and certain DNA mutations in a patient’s stool sample that can indicate cancer and/or precancerous polyps. Cells of DNA are released into the stool continuously as part of the digestive process. There are already at-home screening options

Colorectal Cancer Is (or Could Be) the Poster Child for Cancer Prevention

February is Cancer Prevention Month, and colorectal cancer (CRC) is a poster child, as one of the few cancers that can be literally seen and removed before it becomes cancer, or can be caught early enough in regular screening to be literally cured. Ponder these facts, based on 20 years of experience and summarized by Linda Rabeneck, MD, MPH of Cancer Care Ontario at the recent “GI-ASCO” (Gastrointestinal Cancers Symposium of the American Society of Clinica Oncology):   Annual stool tests (fecal occult blood test, or FOBT) reduce deaths from colorectal cancer by 15 to 33 percent. The newer FIT stool test (fecal immunochemical test) appears to be even better than the

Giving Patients a Screening Choice Matters

When patients  were offered a choice of colorectal cancer screening with either FOBT or colonoscopy, they were significantly more likely to complete that screening than when their doctors recommended only FOBT or only colonoscopy. Nearly 1000 racially and ethnically diverse patients in urban primary care practices were randomly assigned to get colorectal cancer screening via: Fecal occult blood testing (FOBT) Colonoscopy, or Their choice of either FOBT or colonoscopy. Overall, 58 percent were screened within the next year. 

Patients Not Keeping Up with FOBT Screening

Once is not enough for FOBT! Fecal occult blood test (FOBT)  is an effective colorectal cancer screening method, but it needs to be repeated every one or two years to reduce the risk of dying from colon or rectal cancer. But almost half of a group of insured patients initially screened with fecal occult blood testing didn’t follow-up with another FOBT within two years, as recommended.

Annual Fecal Occult Blood Test Cost-Effective Screening Option

What’s the best way to get large groups of people screened for colorectal cancer? Surprisingly it may not be colonoscopy but fecal occult blood testing (FOBT). A computer model has found annual home testing with a  fecal occult  blood test, either Hemoccult II® or Hemoccult SENSA®,  is more cost-effective than colonoscopy every 10 years to screen people of average risk for colorectal cancer. The model compared the number of life years saved under several scenarios of costs and  compliance with annual testing and follow-up colonoscopies after positive guaiac tests.  For the same fixed budget, more people could be screened with an FOBT and more life years saved.

Many Doctors Doing Colorectal Cancer Screening Wrong

FOBT screening saves lives, but only when it is done right. Three out of four primary care doctors did a fecal occult blood test once during an office visit, a method that is ineffective in finding cancer or preventing death from colorectal cancer. One out of four used the in-office test exclusively. Less than half of doctors had a system in place to be sure that home tests were completed and returned. 

More Choices Increase Colorectal Cancer Screening Use

When people were offered a personal choice of either FOBT or colonoscopy screening by their primary care provider, more actually completed the test they chose than if only one option was offered. In a study of  1,000 ethnically and racially diverse people, the lowest percentage had a colonoscopy when that was the only test offered.  More completed fecal occult blood testing if it was the single choice. Overall 65 percent of the 1,000 patients studied were screened after their doctor recommended testing.

Experts Recommend Changes for Colorectal Screening Access and Quality

The first priority of an expert panel looking at increasing the number of people being screened for colorectal cancer was to “Eliminate financial barriers to colorectal cancer screening and appropriate follow up.” Meeting for two days in Washington in February, a National Institutes of Health State-of-the-Science conference considered what is known– and not known– about why people choose or avoid screening, how to improve screening quality, and what the healthcare capacity is to deliver colorectal cancer screening to the US population. At the end of the meeting, the panel released a consensus statement with their recommendations for enhancing the use and quality of colorectal cancer screening.

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