New Tool for Detecting Colon Cancer

Patients dreading colonoscopy now have another non-invasive option for detecting colon cancer.
The Food and Drug Administration recently approved Cologuard, a DNA test to screen for colon cancer in people with no symptoms and an average risk of developing the disease. It’s the first test of its kind to be granted clearance by the FDA. 

Cologuard detects genetic mutations associated with colon cancer in a patient’s stool sample. How? As cancer cells are shed into the intestine, they pass through with the rest of the colon’s contents. Cologuard is able to detect abnormal patterns in the DNA of cells passing as waste.

Although not as sensitive at detecting cancerous or precancerous growths as colonoscopy, which is the gold-standard, Cologuard is more sensitive than the current, best non-invasive test – fecal immunochemical test, or FIT. The new test is also better able to detect pre-cancerous growths that can be surgically removed.

Patients dreading colonoscopy now have another non-invasive option for detecting colon cancer.

The Food and Drug Administration recently approved Cologuard, a DNA test to screen for colon cancer in people with no symptoms and an average risk of developing the disease. It’s the first test of its kind to be granted clearance by the FDA.

Cologuard detects genetic mutations associated with colon cancer in a patient’s stool sample. How? As cancer cells are shed into the intestine, they pass through with the rest of the colon’s contents. Cologuard is able to detect abnormal patterns in the DNA of cells passing as waste.

Although not as sensitive at detecting cancerous or precancerous growths as colonoscopy, which is the gold-standard, Cologuard is more sensitive than the current, best non-invasive test – fecal immunochemical test, or FIT. The new test is also better able to detect pre-cancerous growths that can be surgically removed.

Cologuard, compared with FIT, was 20% more effective at detecting colorectal cancers, and provides the best chance of being cured – 93%, compared with 73% for FIT, according to a study published in the New England Journal of Medicine.

Unlike FIT, Cologuard does not rely exclusively on detecting blood hidden in the stool sample. While most large polyps or cancers shed blood, early-stage tumors may not. Tests like FIT may miss precancerous growths if they are not leaking any blood.

Detection of precancerous growths is important because their removal can significantly reduce the likelihood of them progressing to cancer.

Most doctors still recommend colonoscopy as the most reliable and sensitive test for colon cancer, although that test still may miss up to 10% of precancerous polyps and cancers. Cologuard has not yet been recommended by the U.S. Preventive Services Task Force.

Many people are reluctant to undergo the rigors of prepping for colonoscopy, and dread the procedure itself. Consequently, an estimated 23 million Americans between ages 50 and 75 are not getting screened as recommended.

Cologuard could help identify many additional people at risk of colon cancer. Colorectal cancer, the second leading cause of cancer death in the U.S., can be effectively treated if caught early enough. When detected at an earlier stage, the five-year survival rate of colon cancer can be as high as 90%. An effective, non-invasive test like Cologuard could help save the lives of those who would otherwise remain unscreened.

Not all insurance companies cover the cost of the Cologuard test. It’s best to check first with your insurance company before undergoing it. For those without insurance, the Cologuard test will cost about $600, not including the physician visit necessary for prescribing the test.

The Centers for Medicare and Medicaid Services (CMS) has proposed the test be covered for average -risk people ages 50- 85. CMS is seeking public comments on the proposed ruling before it makes a final decision. It’s expected that CMS will approve coverage for the test within the next few months.

If you’ve been reluctant to schedule an appointment with your doctor to get screened for colorectal cancer, you’re running out of excuses. And while colonoscopy remains the best screening test, talk to your doctor about whether you might be a good candidate for Cologuard testing.