A massive review reaffirms fecal test's place in colon cancer Dx

Scientists continue to push for the development of a more precise, sensitive and cleaner colorectal cancer diagnostic. Now a research team from the University of California, San Francisco, and Kaiser Permanente has determined that a simple, at-home test already on the market is highly accurate.

Details of their review are published in the Annals of Internal Medicine. OncologyNurseAdvisor published the highlights.

Their work looks at data from 19 studies involving 8 separate fecal immunochemical tests (FIT), determining that they were able to rule out rectal or colon cancers for 94% of patients. Additionally, these tests successfully screened for nearly 80% of colorectal cancers, according to OncologyNurseAdvisor's coverage of the research. Patients use the test at home.

As OncologyNurseAdvisor explained, the news is good for colon cancer diagnostics because it shows that the relatively new FIT test (launched in 2008) is highly accurate. What's more, it's a big improvement over the predecessor: an at-home fecal occult blood test that detects, at best, 50% of cancers and require three stool samples, plus special medication and dietary limitations, according to the story. Patients take the FIT test annually in their homes, and most require just one stool sample before sending it to the lab. The test detects small deposits of blood.

All would be a big advance over a colonoscopy, which requires days of preparation. Traditional fecal tests for colon cancer often have low compliance rates and aren't compellingly precise. The data involving the FIT options show promise for next-generation fecal colon cancer tests, however, because of their relative accuracy and minimal patient requirements. Such a test also remains relatively cost-effective, a key requirement in today's healthcare systems.

"FIT is simple, can be done at home and can save lives," lead author Jeffrey Lee of Kaiser Permanente told OncologyNurseAdvisor. "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."

Colon cancer is often not spotted until it is well advanced and more difficult to treat. This reality places enormous importance on existing colon cancer diagnostic options, as well as newer ones coming down the pipeline. Many focus on earlier detection, which would enable doctors to intervene with treatment that then has a greater chance of success.

Progress continues. Last summer, for example, Baylor Research Institute scientists disclosed that they came up with a colon cancer test that seeks out a certain kind of microRNA in the blood. The belief is that it could catch the cancer much earlier than current tests allow, even before it formally takes hold in the body. Germany's Epigenomics, similarly, is trying to advance an early-detection colon cancer diagnostic that would be more efficient and effective than current standards of care.

- read the full story
- check out the journal abstract

Editor's Corner: Germany's Epigenomics bets its future on an early-detection colon cancer Dx

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