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Wednesday, February 19, 2014

Home test for colon cancer may replace colonoscopy

The Take-Home Test You
Might Not Mind Taking

The word “colonoscopy” fills many folks with a sense of dread. If you’re in fear of undergoing this invasive procedure, you’ll be encouraged by new study results from the Kaiser Permanente Center for Health Research in Portland, OR.
The new study concluded that in-home tests requiring patients to collect a single stool sample, then send it to a lab for analysis, will detect about 79 percent of colorectal cancers. I hope these tests will be widely adopted – they’re so much simpler and cheaper than a colonoscopy and could be performed more often. Read on for details. . .
Continued below…

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The procedure is called a fecal immunochemical test (FIT). Kaiser Permanente included eight varieties in the 19 studies reviewed.
The researchers found that all eight tests were fairly sensitive and accurate predictors of colon cancer. And this was true even though most FITs only required one stool sample.
The authors were surprised to find that FIT tests requiring two or three stool samples were no more accurate than those requiring only one. Here are some of the study details:
  • Researchers examined 19 studies that included between 80 and 27,860 patients.
  • Participants’ ages ranged from 45 to 63, and none of them showed any signs of colorectal cancer.
  • Patients in 12 studies took the FIT and received a colonoscopy as well; patients in seven studies only had a colonoscopy if their FIT results were positive (i.e. indicated cancer).
  • Approximately two years later, researchers followed up with patients who had had a negative FIT to determine whether they had been diagnosed with colorectal cancer.
These results were encouraging when compared with an older type of FIT test known as the fecal occult blood test (FOBT). This at-home test is not very accurate. A single round of testing flags only about 13 percent to 50 percent of cancers.
Plus, the FOBT requires three stool samples in tandem with medication and dietary restrictions prior to the test. The FIT test does NOT require people to stop their medications or restrict their diets.
In a Kaiser press statement, lead study author Jeffrey Lee, MD, MAS concluded “FIT is simple, can be done at home, and can save lives. The American Cancer Society and other professional organizations have recommended FIT as a screening tool for colorectal cancer since 2008, but there are still many people who don’t know about it.”
As far as I know you do need a doctor to prescribe the test and review your results with you. But hopefully in the future you’ll be able to buy a kit, send the sample to the lab and receive the results yourself without having a doctor in the loop.
I’m pleased to help raise awareness about this simple testing solution, especially considering that…
Colorectal cancer is a ferocious killer!
The Centers for Disease Control and Prevention (CDC) lists colorectal cancer as Public Enemy #2 when it comes to cancer deaths. Only lung cancer claims more lives each year.
According to National Cancer Institute (NCI) statistics for 2013, about 143,000 people in the United States were diagnosed with this cancer—and nearly 51,000 people died from it.
These cancer cells form in either the longest part of your large intestine (the colon) or in tissues of the large intestine closest to the anus (rectum).
When colorectal cancer spreads, abnormal cells are often found in nearby lymph nodes. From there, the cancer can spread to other lymph nodes or to organs such as the liver.
The treatment methods for colon cancer aren’t pretty…
Surgery may involve simply removing polyps—or part of the colon, too. This can leave the patient needing a colostomy bag to collect wastes from the body.
And you should know that chemotherapy drugs for colorectal cancer can cause the skin on your palms and the bottoms of your feet to become red and painful. It may even peel off!
Radiation treatment also has multiple downsides. It can cause bloody stools…diarrhea… nausea and vomiting… and urgent bowel movements…
Taking a simple, at-home test as a preventive measure starts to sound pretty attractive, right?
So how can you know whether you’re at risk?
NCI lists these factors as possible causes of colon cancer:
  • Age over 50: More than 90 percent of people with this disease are diagnosed after age 50. The average age at diagnosis is 72.
  • Colorectal polyps: These growths on the inner wall of the colon or rectum are common in people 50 and older. Most polyps are not cancerous but some can develop into cancer. Finding and removing polyps may reduce colorectal cancer risk.
  • Family history of colorectal cancer: Close relatives of a person with colorectal cancer are somewhat more likely to develop this disease themselves, especially if the relative had the cancer at a young age. In my view this is more likely because of shared eating habits or toxin exposure rather than genes.
  • Personal history of cancer: A person who has already had colorectal cancer may develop colorectal cancer a second time. Also, women with a history of cancer of the ovary, uterus (endometrium), or breast are at a somewhat higher risk of developing colorectal cancer.
  • Ulcerative colitis or Crohn disease: These conditions can lead to inflammation of the colon for many years; this can increase risk of developing colorectal cancer.
  • Diet: High-fat, low-fiber diets may increase the risk of colorectal cancer.
  • Cigarette smoking: May increase the risk of developing polyps and colorectal cancer.
The NCI list downplays what I would consider by far the most important cause of colon cancer: a diet low in fiber, low in fresh fruits and vegetables, high in sugar and refined carbohydrates (including alcohol), and high in processed and packaged foods.
NCI advises that people at higher-than-average risk of colorectal cancer should talk with their doctor about whether to have screening tests before age 50 and what tests to have.
So what symptoms are common to colon cancer? Basically you should talk to your doctor if you experience a change in bowel habits. This includes finding blood in your stool or stools that are narrower than usual.
Other symptoms may include diarrhea or constipation, frequent gas pains, bloating or cramps, weight loss for no reason, or a feeling that your bowel does not empty completely.
Now, please note: usually these symptoms are not caused by cancer. But if you suspect there could be trouble—visit your doctor right away for a more accurate diagnosis and treatment plan.
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Centers for Disease Control and Prevention. 2014. Colorectal (Colon) Cancer factsheet. Available online at
Lee, J.K. et al. 2014. Accuracy of fecal immunochemical tests for colorectal cancer: Systematic review and meta-analysis. Annals of Internal Medicine. Abstract available at
National Cancer Institute. 2013. What you need to know about cancer of the colon and rectum. Retrieved online at
Sawyers, M. 2014, Feb. 3. Simple, at-home test will detect most colorectal cancers. Kaiser Permanente Center for Health Research. Retrieved from

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