Archive for the ‘Colon’ Category

Update:New Painless Test for Colon Cancer Details – Still Experimental but Hope Abounds.

Monday, November 1st, 2010

Two weeks ago, this blog highlighted the issue of doctors not following recommended colon cancer screening guidelines. While the standard tests for colon cancer (primarily colonoscopy and flexible sigmoidoscopy) will likely remain in place for now, new information is coming out on a new test that may one day be used to detect colon cancer – a DNA stool test.  As reported by and others, the test uses a stool sample and detects alterations in DNA that are linked to the presence of tumors.  Therefore, actual imaging of the colon is not necessary.

The test has been developed by a Wisconsin company called Exact Sciences.  What is key about this new test is that it is non-invasive, meaning that it does not involve any bodily penetration.  This would be a boon for those patients who put off getting tested because they don’t want to undergo more invasive procedures, or who don’t want to take time away from their busy lives to do it.  This new test can even be done at home.

Researchers at the Mayo Clinic have already tried out this new test on humans with surprisingly good results.  On a test involving 1,100 participants, the DNA test detected 85% of cancers and 65% of pre-cancerous adenomas larger than 1 cm.  87% of Stage I to Stage III cancers were caught by the new test, which is excellent news because the earlier cancer is detected, the better chance there is of a cure.

We must emphasize that this new test is experimental only at this stage.  Additional human trials are expected to get underway in 2011.  There is no word on when this test may become available for wide-spread use.  We will continue to post updates on this exciting new front.

Most Doctors Don’t follow Colon Cancer Screening Guidelines

Monday, October 18th, 2010

Each year in the United States, colorectal cancer causes over 50,000 deaths.  Despite the obvious seriousness of colorectal cancer, a new study published in the Journal of General Internal Medicine reports that 81 percent of doctors are not following all recommended colon cancer screening guidelines.  While approximately 40% of doctors follow guidelines for some tests, a shocking 40% don’t follow recommended guidelines for any colon cancer screening tests.

First off, what are screening tests?  A screening test is a test for a certain disease that is given to patients who do not have symptoms of the disease.  This is different from a test that a doctor orders in response to a specific symptom, e.g., a finding of blood in the stool that results in a colonoscopy to discover the cause of the bleeding.  The purpose of a screening test is to catch a disease early, before it gets to the point where it starts to cause symptoms.  The earlier colon cancer gets detected, the better chance the patient has for a successful outcome.  Knowing this, it is difficult to understand why doctors are not following recommended guidelines.

One factor that the study’s authors noted was the age of the doctor.  Younger, board-certified doctors were the most likely to properly follow the guidelines.  Older doctors, on the other hand, were less likely to do so.  It appears that older doctors may be following guidelines that were in effect at the time of their training rather than keeping up to date with current guidelines.  This is not to suggest that the non-compliant doctors are all failing to recommend any screening tests.  The study indicates that some doctors are actually over-using the tests.  This, however, can result in additional risk (e.g., risk of injury from a colonoscopy) as well as unnecessary tests and higher medical costs.

From the patient’s perspective, it is wise to know yourself what the recommended guidelines are so that you can have a meaningful discussion with your doctor about what tests you should be getting and when.  As reported in the linked article:

Here are the American Cancer Society’s current guidelines on checking for colorectal cancer and polyps (often precursors to cancer). Starting at age 50, men and women should follow one of these testing schedules:

To detect both polyps and cancer (preferred) :

To primarily detect a cancer:

Some people may require a different screening schedule due to personal or family history; the cancer society recommends that you talk with your doctor to determine which schedule is best for you.