Early detection of colon cancer can prevent most or much more deaths from the disease 73 percent of them. But only 50 to 75 percent middle-aged and older adults who needs to be screened commonly be checked.
One reason, doctors say, is that screening methods discourage many individuals.
For people at average risk, there are two options: colonoscopy every 10 years or stool examination each one to a few yearsdepending on the variety of test.
Or, as Dr. Folasade P. May, a gastroenterologist at UCLA Health, put it, “either you take this nasty laxative and then the doctor sticks a tool up your butt, or you have to manipulate your own poop.”
But something much simpler is on the horizon: a blood test. Gastroenterologists say such tests could change into a part of routine blood tests ordered by doctors, resembling when a patient is available in for an annual physical examination.
“I think this will start to gain momentum,” said Dr. John M. Carethers, a gastroenterologist and vice chancellor for health sciences on the University of California, San Diego.
ABOUT 53,000 Americans are expected to die from colon cancer this yr. This is second commonest cause cancer deaths within the United States, and while the death rate has decreased amongst older people, it has increased amongst people under 55 years of age.
Current guidelines recommend that screening begin at age 45. The problem is convincing more people to get screened.
Enter blood test. It uses the invention that colon cancer and enormous polyps – clusters of cells in the liner of the big intestine that sometimes turn into cancer – excrete DNA fragments into the blood.
AND test published Wednesday in The New England Journal of Medicine found that a blood test for such DNA called Shield and performed by Guardant Health detected 87 percent of cancers in early and curable stages. The false positive rate was 10 percent.
“This will be big news,” said Dr. May, a consultant for Exact Sciences, maker of the Cologuard stool test.
However, the blood test has one caveat: it detects cancer but misses most large polyps, finding only 13% of them. In contrast, stool testing detects 43% of cases and colonoscopy detects 94%, says Dr. Carethers.
Although polyps are often harmless, a couple of of them can turn into cancer, so doctors want to seek out and take away all of them to stop cancer from developing.
Dr. Barbara Jung, chair of the University of Washington’s department of drugs and president of the American Gastroenterological Association, said patients needs to be fully informed before opting for a blood test. In particular, they need to grasp that while this test helps detect cancer early, it doesn’t prevent it since it isn’t good at detecting pre-cancerous polyps.
“We need to have this discussion” with patients, she said. But she added that “much of this burden will fall on primary care physicians, who are already running out of time to get through the litany of check-ups and counseling.”
Doctors can even need to elucidate to patients that if the blood test results are abnormal, they are going to must schedule a colonoscopy to detect polyps or cancers at an early stage and take away them, if present.
It can also be unclear how often blood tests needs to be performed. Guardant suggested every three years, but that advice isn’t well established, Dr. Jung said.
Dr. Jung added that she would very very like to know whether the blood test gives good ends in people too young to qualify for existing screening tests. However, this can require additional research. He worries concerning the rising variety of colon cancer cases in younger people. It could be “very attractive,” she said, if people over 30 could get a blood test for colon cancer.
“That would be the biggest excitement for me,” Dr. Jung said.
However, the large unknown is the prices. Guardant has asked the Food and Drug Administration for approval to bring the test to market. The company currently markets it as a “lab test” that doesn’t require FDA approval but can also be not covered by medical health insurance. For those willing to pay out of pocket, the value is $895. However, said Matt Burns, a spokesman for Guardant, the corporate will work with Medicare and Medicaid and personal insurers to “finalize a price” whether it is approved, said Matt Burns, a spokesman for Guardant.
Dr. William Grady, medical director of the gastrointestinal cancer prevention program at Fred Hutchinson Cancer Center and corresponding creator on the Guardant-sponsored study, said the corporate might conform to a price that will be comparable to a different drug. screening methods. Cost of Cologuard stool test $581-$681. Colonoscopies, normally needed half as often, normally cost money $1,250 to $4,800, although some hospitals charge more. The average cost of a colonoscopy within the United States is $2,750. Tests are often covered by insurance.
Dr. May cautioned that patients should know that the three screening tests should not equivalent. She said that with blood testing, “we are moving from prevention to early detection.”
But, she said, the blood test is kind of easy. When your doctor orders a routine blood test, just add a test for colon cancer.
“It’s phenomenally exciting,” she said.
And the convenience of use may outweigh the test’s limitations, said creator Dr. Carethers editorial within the journal accompanying the study. Ultimately, the goal of screening is to cut back deaths from colorectal cancer in the general population.
If the blood test implies that many more people shall be screened, the result – fewer deaths from colorectal cancer – shall be favorable.
“The best screening test is the one the patient completes,” he wrote.
