Is At-Home Stool Test a Colonoscopy Alternative?
https://ift.tt/2GJSuqV An editorial published with the study points to some hard numbers: Only two-thirds of Americans aged 50 to 75 have been screened for colon cancer, mostly by colonoscopy. Of the one-third who remained unscreened, many are lower-income, uninsured or "underinsured." Greater awareness of cheaper, easier FIT screening -- among doctors and patients alike -- could help close that gap, said Dr. James Allison, the editorial author. For years, Allison said, the media and health systems have promoted colonoscopy screening as the "gold standard" -- while FIT is often regarded as "second-best." But the evidence does not support that. "There is no single best test for colon cancer screening," said Allison, who is with the University of California, San Francisco and the Kaiser Permanente Northern California Division of Research. And, he pointed out, guidelines on colon cancer screening do not advocate any one test over the others. Guidelines from the U.S. Preventive Services Task Force say that people at average risk of colon cancer should begin screening at age 50. The American Cancer Society suggests age 45. But both groups say screening can be done with stool tests, colonoscopy or sigmoidoscopy (another invasive test). Colonoscopies are much better than FIT at detecting polyps -- benign growths that occasionally become cancerous. But, Imperiale said, research suggests that large, "advanced" polyps transition to cancer at a rate of 3 to 6 percent per year. So if one FIT misses a large polyp, there's a good chance it will still be caught during subsequent tests. And while colonoscopies are generally safe, they do carry small risks of bleeding, infection or bowel tears. "We need to recognize that FIT is at least as good as colonoscopy," Allison said. There is another type of stool-based screening test available, called Cologuard. It looks for both hidden blood and certain DNA changes that can be found in colon cancers or polyps. But the test is expensive -- around $500 -- and there's no proof it's better than FIT screening, Allison said. People who choose stool testing will not necessarily avoid a colonoscopy. If blood is detected, you'll need a follow-up colonoscopy -- and it may turn out to be a false alarm. Keeping up the yearly schedule is also key, Imperiale said. Health via WebMD Health https://www.webmd.com/ February 26, 2019 at 08:11AM
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