A good colonoscopy alternative? It would seem so.

By ACSH Staff — Oct 28, 2014
Colon cancer is the third leading cause of cancer-related deaths in the US. In 2014, more than 96,000 people developed new cases, and there will be an estimated 50,000 deaths. It is also one of the most preventable cancers: if all Americans followed recommendations about getting a colonoscopy, the death rate from colorectal cancer (CRC) would plummet. However, current methods, as well as patient fear, are common reasons why people do not undergo this crucial test.

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Colon cancer is the third leading cause of cancer-related deaths in the US. In 2014, more than 96,000 people developed new cases, and there will be an estimated 50,000 deaths.

It is also one of the most preventable cancers: if all Americans followed recommendations about getting a colonoscopy, the death rate from colorectal cancer (CRC) would plummet. However, current methods, as well as patient fear, are common reasons why people do not undergo this crucial test.

While many people fear the procedure (let s face it it s not the nicest visual), the actual colonoscopy itself involves nothing more than a very pleasant nap. The day before is not so pleasant, since it involves a cleansing procedure that is not really dinnertime conversation. It ranges from unpleasant to more unpleasant.

For those people who cannot or will not tolerate the prep, there is an alternative home test kit called Cologuard, which was developed by the Mayo clinic, and is being marketed by Exact Sciences Corp., a 19-year old company based in Madison, Wisconsin. The test kit was approved by the FDA in August 2014.

ACSH s Dr. Josh Bloom says, All things equal, the colonoscopy is a superior choice, since it does a better job in detecting nascent cancers ( pre-malignant ) even earlier as polyps, which are not cancerous, but often turn into to cancers with time. And, polyps can be removed during the procedure, which actually prevents cancer rather than detecting it early. However, although not perfect, this test will undoubtedly save lives.

The technology behind the test is quite elegant. It is certainly an improvement over the commonly-used fecal occult blood test, which will pick up cancers at later stages, plus non-cancerous conditions that cause bleeding. Instead, Cologuard detects the presence of markers of a particular type of DNA that is produced only by cancerous cells. And it does so quite accurately. Cologuard detected the presence of markers of cancer cells 92 percent of the time, although 13 percent of these turned out to be false positives. Still, not half bad. The test also detected polyps, but only 42 percent of the time. However, it did a better job (66 percent) in detecting larger, and thus, more dangerous polyps.

ACSH s Dr. Gil Ross is a fan. He says, Given the reluctance of a substantial fraction of Americans to undergo the prep as well as the procedure that would reduce their risk of CRC and its sequelae, this at-home test seems like a major benefit. The real bugaboo of such tests are the false negatives, where the patient is given a false sense of security, which can prove lethal. False positives are a problem of a lesser sort. The Cologuard test will surely not eliminate the need for encouraging people to get tested with direct vision, but it appears to provide an alternative that will help save lives.

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