A One-Two Punch for Colon Cancer
A new approach to colorectal cancer screening may increase both accuracy and patient compliance
Michael Schubert |
At a Glance
- Colorectal cancer screening poses many challenges – chief among them low patient compliance and high false positive rates in noninvasive single-marker tests
- Noninvasive testing, especially if it can be conducted privately at home, can increase patients’ willingness to be screened
- Noninvasive multiple-marker testing that combines DNA alterations and hemoglobin detection can lead to a more sensitive test
- A new multi-target, stool-DNA-based test is currently showing success in the United States, with an eye to European and Asian expansion in the future
Colorectal cancer (CRC) is a disease full of challenges. It’s awkward for patients to discuss, difficult to treat if not diagnosed early, and prone to high rates of screening noncompliance, thanks to challenges with stool collection and the necessary bowel preparation for colonoscopy. Even among patients who do submit to noninvasive screening, those who undergo fecal immunohistochemistry testing (FIT) alone run about a one-third risk of false negatives for cancer, almost all of which are early-stage, and a two-thirds risk of false negatives for significant precancerous lesions, especially sessile serrated adenomas (SSAs), which do not bleed. Taken together with noncompliance with annual screening, the outlook for FIT is pretty dismal for CRC prevention and early-stage treatment – but what can be done about it? Barry Berger is part of a team that has developed a noninvasive, in-home test that patients can perform at their leisure. The test uses a multi-target approach that looks for both fecal hemoglobin and DNA markers – and based on their results so far, it might just improve compliance, increase screening success rates, and contribute to decreasing CRC-related mortality and morbidity.
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