Winning the war on colon cancer through screening

Published 9:37 am Friday, December 11, 2015

by Dr. Bunan Alnaif

Due to increased awareness, 75 percent of women today are up to date with breast cancer screening, including breast exams and mammograms, improving rates of early detection and saving countless lives. Similarly, rates of cervical cancer have declined steadily since introduction of the Pap test 70 years ago and even more so since approval of ThinPrep in the 90s. In fact, 80 percent of women are in compliance with recommended screening, and the number of cervical cancer deaths has dropped by 50 percent over the past three decades.

Now, many are hoping that with increased attention and awareness, we can see similar improvements in the survival rate for colon cancer. The disease will claim close to 50,000 lives this year alone — more than cervical and breast cancer combined. The main issue is that, despite the deadly statistic, compliance with colon cancer screening remains low, but there are steps you can take to protect yourself.

Screening is critical because most colon cancers develop slowly over several years. In fact, before cancer develops, a polyp — or non-cancerous growth — usually appears on the inner lining of the colon or rectum. These polyps may take 10 to 15 years to become cancer, so early identification and removal of them can effectively prevent cancer from ever forming. In addition, because most polyps and early-stage cancers cause no symptoms, the only way to detect them early is through regular screening.

The American Cancer Society recommends that men and women get screened for colon cancer beginning at age 50; unfortunately, only half of those who should get screened actually do. As a result, many patients aren’t diagnosed until the late stages, when treatment is difficult and survival rates low.

The challenge with colon cancer is that while the most widely adopted screening option — colonoscopy — is highly effective, the procedure is invasive and requires bowel preparation and sedation a majority of the time, making it undesirable for many. In fact, compliance with colonoscopy is a mere 38 percent.

Approved by the FDA in 2014, Cologuard might be just what the doctor ordered. Unlike other at-home tests — such as the fecal occult blood test (FOBT) and fecal immunochemical test (FIT), which only look for blood in the stool — Cologuard analyzes a patient-provided stool sample for the presence of both DNA and blood biomarkers known to be associated with cancer and precancers. It is this combination of blood and DNA detection that makes Cologuard a powerful new weapon in the war on colon cancer.

Taking the test is simple. First, a licensed healthcare provider prescribes the test, and a collection kit is sent to the patient’s home. The patient collects a stool sample at his or her convenience (no medication, dietary restrictions, bowel preparation, sedation, time off of work or transportation required) and sends the kit back to the lab for testing in a pre-paid mailer. The patient receives the results from his/her physician in as little as two weeks after sending in the sample. If the result is positive, the clinician will refer the patient for a diagnostic colonoscopy. If the test is negative, the patient should continue to participate in a screening program at an interval and with a method appropriate for them based on discussion with their clinician.

In just its first year on the market, this patient-friendly test has seen patient compliance rates above 70 percent (close to double the rate for colonoscopy), suggesting that it’s motivating people to follow through with screening.

Much like breast and cervical cancer, colon cancer deaths can be prevented with improved education, awareness and screening. New options make getting screened easier than ever before, so if you’re over 50, make sure you get screened for colon cancer too.

Dr. BUNAN ALNAIF is an OBGYN at Western Branch Center for Women. She can be reached at 484-7200.