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Saturday, January 3, 2015

Fecal DNA Testing: Passing Fancy or the Demise of Colonoscopy?

Fecal DNA Testing: Passing Fancy or the Demise of Colonoscopy?

For many years, there have been attempts to find easier and less expensive alternatives to colonoscopy as a means to screen for colorectal cancer. The stakes are quite high. There were an estimated 136,830 new cases of colorectal cancer in the United States in 2014, and 50,310 deaths from colorectal cancer in the same period.  The estimated 5 year survival is approximately 64.7%

As alarming as these statistics are, there has been a clear trend toward improvement since the advent of routine screening colonoscopy. Medicare began to pay for screening colonoscopies in “high risk” individuals in the 1980's and 1990’s and began coverage for average risk people in 2001.  Most analysts attribute the steady decrease in the rate of new cases and deaths from colorectal cancer to the more widespread acceptance of screening colonoscopy. In fact, it is estimated that if everyone age 50 (the recommended started point for most patients)and up were screened via colonoscopy, it would result in an 80% prevention of colon cancer, and a 60% reduction in deaths from colon cancer.

Despite these compelling facts, it is estimated that at least one in three Americans of the appropriate age(50-75)has not been tested for colorectal cancer, and therefore is needlessly at risk for this preventable problem. The reasons for this are multiple, and include inadequate public awareness, cost, inadequate access to medical resources, and fear of what some perceive to be an invasive medical procedure.

Current guidelines indicate that colonoscopy is the superior method for screening, since it effective for both early detection of colorectal cancer, as well as prevention(by detecting and removing pre-cancerous polyps). Average risk individuals are advised to have colonoscopy starting at age 50(45 for African Americans), then every 10 years if normal. For individuals who decline colonoscopy, yearly FIT(fecal immunochemical testing) is advised as an alternative.  This is a test that can detect tiny amounts of blood in the stool, which may indicate the presence of a colon tumor. While FIT is less invasive than colonoscopy(it involves submitting a scraping from a stool specimen), it is problematic in the sense that it is less likely to pick up cancers than colonoscopy, only detecting 79% of cancers.

To try and combat this lower rate of detection, researchers have combined the FIT test with a fecal DNA test, which can detect abnormal DNA in the stool, which has been shed by tumor cells in the colon.  The results were encouraging. The DNA test discovered 60 of the 65 cancers for an accuracy rate of approximately 92%.  The cost, according to Cologuard, by Exact Sciences Laboratories, is $599.

The role for fecal DNA testing remains to be seen. Like FIT, it is less likely to find colon cancers than colonoscopy. If it is utilized routinely to screen individuals, other issues such as the high false positive rate(meaning an abnormal stool test, when there is actually no tumor present), as well as the frequency with which such tests should be done, must be resolved.
Where does fecal DNA and FIT “fit” into my practice?(sorry-couldn’t help it!). I continue to recommend colonoscopy as the screening test of choice. It is hard for me to offer other tests as “first line”. Colonoscopy is the “gold standard” for accuracy, is well documented to save lives, and has withstood the test of time as en effective tool for detecting, and preventing colon cancer.

I offer fecal DNA testing and/or FIT as an alternate strategy for patients who refuse to undergo colonoscopy, or who-because of other serious medical conditions-may be poor candidates for colonoscopy. While cost and accuracy with fecal DNA testing remain a problem, it definitely represents an advance by offering another tool in the fight against colon cancer.







http://www.hrsa.gov/quality/toolbox/measures/colorectalcancer/

http://www.cologuardtest.com/how-billing-works

6 comments:

Rick Ealno said...

Bowel cancer has become the most frequently occurring cancer (other than skin) in Australia. So it is important to create awareness among people about the cancer. http://colorectal-surgeon.com.au/ check out the website to know about the treatment methods.

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Rick Ealno said...

Informative.. I was diagnosed with colon cancer 5 years back .. I had to go through colonoscopy at CSCS , Sydney test for few hours to make I am cancer free.

Morgan Phelps said...

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MuscleSquad said...


Have you got constipation? Well, most of us do, Especially, when we talk about today's sedentary lifestyle & diet habits of most of us!

So, in this article I am going to talk about natural remedies that you can do at your home to cure irritable bowel syndrome(ibs), constipation, diarrhoea, diverticulitis and ulcerative colitis. the remedies that I am going to present here are helpful in providing relief on above mentioned diseases.

Home Remedies :

1. Drink water regularly. At least 6 glasses of water a day would be very great and therapeutic. Large amounts of water aids quick digestion and enables easier bowel movement.

2. Adding roasted black gram powder to chapatti made of wheat including the husks too can enhance constipation relief.

3. Molasses which have high calorie content are also very good. Beware though as it has a strong taste and you’ll want to add fruit juice or milk to it when taking it. All you really need is two tablespoonfuls of blackstrap molasses just before sleeping at night.

4. Take half a cup of cabbage juice twice a day. This is very effective in treating and curing constipation.

5. If you have got access to mango, take one in the morning right after brushing before breakfast, and one at night after dinner. Mangoes are very effective bowel movers. There is a sure guarantee that you’ll have to “go” at least twice before nightfall.

6. Create a mixture of Spiegel seeds and warm milk. This is done by dipping the Spiegel seeds (5-10g) in warm milk (200g). To this, mixture, add sugar and you have for yourself a highly effective treatment method.

7. If you are suffering from chronic constipation, take a drink of figs dipped in water in the morning. If taken in copious amounts, you’ll definitely find yourself reaching for the next available toilet.

8. if you want instant relief from constipation, drink water that has been kept in a copper container and has been left overnight. It acts as a superb constipation relief.

9. Get half a glass of water and mix one-quarter (¼) of Epsom salts with it for fast constipation relief.

10. Also try pouring a whole sachet of Andrew’s Liver Salt in a glass of water sand gulp down immediately. This will also produce a fast constipation relief.

CONCLUSION:

The health of your Colon has a vital importance these days. Due to increased chances of Colon Cancer, patients have to go through a lot of pain during Colonoscopy. also Colon Cancer Symptoms are not that easy to identify, therefore Colon Cleansing is very important these days. A Clean Colon will also help in Weight Loss and prevents the Signs of Colon Cancer or Colorectal Cancer. We at HealthPrivates.com provide you Natural Homeopathic Medicines for Colon Cleanse, Irritable Bowel Syndrome,Colon control and Colon Probiotics.

You can check these products here:

https://healthprivates.com/colon-health

Until next Article Happy Lifting.

Regards,
Nishant Raheja,
Health Privates
Support@healthprivates.com