[ad_1]
Breaking News Emails
Receive last minute alerts and special reports. News and stories that matter, delivered in the morning on weekdays.
By Linda Carroll
A new study suggests that for colon cancer screening, an annual stool test can be as effective as colonoscopy for people who do not have risk factors for the disease.
The researchers analyzed data from 31 studies including more than 120,000 medium-risk patients, who had undergone stool testing and colonoscopy. They determined that the fecal immunochemical test – or FIT – is sufficient to screen for colon cancer, according to the report published Monday in the Annals of Internal Medicine.
FIT is designed to detect hemoglobin, a protein found in red blood cells. People who test positive for FIT should have a colonoscopy to determine if they have cancer or precancerous lesions. But those who test negative must only continue to receive FIT every year to make sure they do not develop colon cancer.
"This non-invasive test for colon cancer screening is available for people at moderate risk," said lead author of the study, the gastroenterologist Dr. Thomas Imperiale, a researcher at the Regenstrief Institute in Indianapolis. . "They should discuss with their suppliers the opportunity for them."
FIT is done at home by the patient and sent to a laboratory for evaluation.
The only disadvantage of home stool testing is that it must be done every year. But if it's used every year, the test is enough to detect the vast majority of cancers, Imperiale said.
Switching from colonoscopy to FIT for medium-risk, symptom-free patients would bring colon cancer screening more in line with other cancer screenings, such as mammography and Pap smears, because, like them, it is non-invasive said Imperiale.
Although rare, colonoscopy can lead to serious complications, such as perforation of the colon, which occurs in about one in 1,000 cases, said Imperiale. Performing FIT involves very little risk.
Before being subjected to colonoscopy, many patients experience fear and anxiety, which can lead to negative experiences. Some doctors believe that the use of FIT may result in more people being screened for colon cancer. Currently, 35% of people who should have a colonoscopy do not have one, the researchers said.
FIT could also be a better option to screen people under 50 years old, currently recommended for colonoscopy. Recent studies have shown that colon cancer strikes younger and younger, and as a result, the American Cancer Society has suggested reducing the age of first colonoscopy to 45 years.
Despite this recommendation, it is unlikely that an insurer pays for a colonoscopy in younger patients, said Imperiale. For these patients, "using FIT for screening makes sense: the test itself is safe, non-invasive, inexpensive and will detect at least three of the four cancers in the first application," she said. he adds.
FIT is an excellent option for colon cancer screening only if it is done consistently on an annual basis.
In this study, Imperiale and her colleagues determined that when FIT needed to be more sensitive, the test detected 95% of cancers, but resulted in 10% false positives. In a less sensitive context, FIT detected 75% of cancers, but only 5% of false positives.
But, by performing the test every year, things improve dramatically, bringing the detection rate back to just two years closer to that of the more sensitive parameter, said Imperiale.
Experts cautioned that although ITT is less invasive, patients may not follow the recommendations for testing every year.
"FIT is a great option for colon cancer screening only if it's done every year," said Dr. Felice Schnoll-Sussman, a gastroenterologist at New York-Presbyterian Hospital and Weill Cornell Medicine. "Screening for colon cancer and its impact on lowering colon cancer rates is a success story in preventative health, although we still have some way to go to reach the previously set goals of 80% in the US by 2018 ".
FIT has the ability to increase filter rates, "as long as we create the infrastructure to do it in a high quality way," Schnoll-Sussman said in an email.
Dr. Robert Schoen also fears that patients will not be tested every year, but it may still be more effective than having a colonoscopy every 10 years.
"We know that when we do a colonoscopy, we find nothing in 60% of cases," said Schoen, professor of medicine and epidemiology and head of gastroenterology at the University of Pittsburgh Medical Center. . "It's not very effective."
FIT seems to work in countries like the Netherlands, Spain and France, said Schoen.
"They are all doing centralized FIT screening," he added. "It's a lot cheaper and still a very effective means of screening and that's a good thing."
[ad_2]
Source link