Joseph R. Anticaglia MD
Medical Advisory Board
Nick, a 20 year veteran of the Cleveland Fire Department said: “My family has a history of colon cancer. When I was 50 years old, I started to get routine colonoscopies. I told the nurses in my doctor’s office that I’m a healthy guy and don’t take any medicines. They told me to strictly follow the colonoscopy preparation instructions which went something like this:”
“A week before the colonoscopy, don’t take aspirin or anything that can thin the blood — things like vitamin E or multivitamins. About five days before the test, don’t eat fresh or dried fruit, nuts, and avoid whole grains and cereals. The day before the colonoscopy, drink only clear liquids — no solid foods. And remember to take the prep solution.”
“For me, the worst part of colonoscopy was the “prep,” the phosphate solution you had to drink before the procedure. When I heard there was a home test for colon cancer, I started to read up on it”
Colorectal or Colon Cancer is a leading cause of cancer deaths in the United States. More than 145,000 people are diagnosed with cancer and more than 53,000 die from colon cancer each year in the U. S. The key to knocking down these numbers is to make people aware of screening tests that diagnose cancer in its earliest stages. The American Cancer Society recommends screening with a visual exam, for example, colonoscopy or a stool-based home test.
The FIT Home Test
A noninvasive alternative to colonoscopy is the FIT test (fecal immunochemical test). It is a home stool-based test that’s used to identify occult blood in the feces. Studies suggest it has a high degree of reliability to detect colon cancer. It’s a screening option in adults 45 years of age or older at average risk for colon cancer.
A stool sample is collected at home and sent to a laboratory for evaluation. In less than a week, the laboratory will mail you and your doctor the results of the FIT test. If the test shows evidence of blood in the stool, contact your physician and make arrangements for a colonoscopy. The test is repeated annually. The FIT test detects 70% of colon cancer, and 30% of large polyps. False-positive, and false-negative results have occurred.
DNA Home Test (Cologuard)
A stool sample is collected at home and sent to a laboratory for evaluation. Besides looking for blood in the stool, this test is designed to identify DNA markers associated with colon cancer. It too is a screening option in adults 45 years of age or older at average risk for colon cancer.
The idea of DNA markers is that the inner lining of the colon sheds normal and abnormal cells which are picked up by the stool. This technology can identify altered cells in the stool sample indicative of precancer and caner. A positive test requires a follow-up colonoscopy. The test is repeated every three years. The DNA Cologuard detects 92% of cancer and 40% of large colorectal polyps. False positive, and false negative results have occurred.
Advantages of Home Tests
Colon home tests offer the advantage of comfort and convenience. With these tests there’s no need to empty the bowel ahead of time, you avoid sedation, no need to ask someone to drive you home after the procedure and there’s no time lost from work.
Disadvantages of the home tests occur when the report indicates the presence of disease (blood or altered cells) when none is present (false positive result). The opposite has also been reported (false negative result). The cost of the home test varies and it’s worthwhile to check your insurance coverage.
Pushback
COVID-19 has put an end to more than 865,000 lives thus far in the United States! It’s understandable that people, fearful of contracting COVID, refuse to go to hospitals or surgical centers to undergo a colonoscopy. At other times, patients may not be healthy enough for the colonoscopy. Sometimes people right out refuse to have a colonoscopy. In these instances, colon home tests are an option.
Home tests can play a key role in the prevention of colon cancer. If you have a positive home test result, make arrangements to have a colonoscopy. Since Nick has a strong family history of colon cancer, he decided to continue with periodic colonoscopies. Colon cancer is avoidable and curable.
References
- CDC, Colorectal (Colon) Cancer; February 8, 2021
- Cancer. net; Colorectal Cancer Statistics
- Andrew M. D. Wolf MD et al; Colorectal cancer screening for average‐risk adults: 2018 guideline update; American Cancer Society, May 30, 2018
- Mayo Clinic Staff; Colon cancer screening: Weighing the options; December 5,2020
- Gastroenterology Consultants of San Antonio; The Truth About Cologuard Tests, March 27, 2019
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.
