Colonoscopy Remains Gold Standard for Colon Cancer Screening

New screening options should be used with caution, risk factors in mind

TROY, Ohio (June 13, 2018) – The idea of undergoing a colonoscopy can make nearly anyone squirm. So, when a less invasive screening method comes along, it’s going to get noticed.

However, one local gastroenterologist says individuals need to approach other screening tests with caution and consider their personal risk for colon cancer before choosing newer methods over the colonoscopy’s proven track record.

“The gold standard for colon cancer screening is the colonoscopy,” said Kenneth Reed, DO, with Premier Gastroenterology Specialists. “It’s a very good test because you can not only prevent colon cancer, but also diagnose it. If someone has a polyp then you can find it, remove it and help prevent the disease. Likewise, if we discover an early stage cancer, then we can find it, mark it and know exactly where it is at.”

 Other tests – some older and some newer to the market – are less invasive and don’t require a person to undergo sedation or experience the often dreaded preparation the day before. However, they also leave room for error or, in some cases, may require a follow-up colonoscopy once something is found, said Dr. Reed, who practices with Premier Physician Network.

The other colon screening options include:

Fecal immunochemical test (FIT) – This test checks the stool for DNA or gene changes found in cancer cells. FIT has a 13 percent false positive rate and must be performed every one to three years. Those who receive a positive FIT test are often referred to have a colonoscopy.

Fecal occult test – This screening checks for hidden blood in the stool, which can be an early sign of cancer. The test has a 15 percent false positive rate and should be performed every year. It is generally not used to diagnose colon cancer. Dr. Reed said this test is a very old one that has “fallen out of favor because it is not specific or sensitive enough to deliver the accurate results needed.”

Cologuard – This is the newest offering for colon cancer screening. It uses a person’s DNA, rather than blood, to indicate the presence of tumors. The test is approved by the Food and Drug Administration (FDA), and advertises itself as a colon cancer screening that’s as easy as “going to the bathroom.” However, providers like Dr. Reed argue it still is less accurate than a colonoscopy.

“Most of these tests are finding colon cancer when it has already occurred,” Dr. Reed said. “If you do a stool test for blood or a FIT test, and they become positive that means there is something there that is causing the test to become positive. Colonoscopies remain the only test that can help prevent colon cancer because we are able to find polyps that need to be removed before they become cancerous.”

It’s important to keep in mind the risk factors for colon cancer. These include age, family history and existing medical conditions such as inflammatory bowel disease. Individuals who have one or more of these may want to speak to their physician prior to considering screenings other than a colonoscopy.

There are times when certain factors keep a person from having a colonoscopy such as cost restraints, and a fear of being sedated. In these limited situations, it may be good that alternative options are available, he said.

“Anything to try to get people to get tested would be preferable to having nothing done,” Dr. Reed said.

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