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New Simple Stool Test May Replace Dreaded Colonoscopy

Kaiser Permanente researcher, Gloria Colorado, Ph.D., is investigating whether a simple, single-sample, home stool test could make colon health more accessible. The FIT test nearly doubled colon screenings over nine years, and was 79% accurate for the presence of colorectal cancer.

Health care groups are concerned about health care because colorectal cancer is the second highest cause of cancer deaths, and the 3rd most common cancer in the US. And yet up to 80% of cases can be treated if caught early, so it’s highly treatable. Regular screening after age 50 is recommended, every 10 years usually. (Colorectal is an mash-up of colon and rectal.)

There are often few signs and symptoms (read more about signs at www.FightColorectalCancer.org, which includes no sign, blood in stool, constipation, diarrhea, fatigue, weight loss, gas, change in bowel habits).

Colonoscopy: Past Screening Method for Colon Cancer
Most people dread the long process of getting ready for a colonoscopy, which involves drinking a gallon of solution in a day to purge the bowels (read: all day on the toilet). It then involves the anesthetizing of the patient during the exam. A scope (camera) is sent up the colon to see what’s going on.

Aside from being inconvenient, colonoscopies are also costly, about $800-1200. Health insurance often covers them. Doctors feel that it’s necessary to do a colonoscopy when patients have diarrhea and bloody stools. It is hard to know what’s going on inside, after all. [Patients without health insurance can get a low-cost or free colonoscopy through these groups.]

Meet the New FIT Test: Single Sample Fun
Dr. Colorado is a proponent of the FIT test, which stands for Fecal Immunochemical Test. Dr. Colorado sent out two hundred FIT tests to Oregon residents, many of whom were not already covered by health insurance plans, and came back with a 40% response rate! (Normal mail response rates are 1-2%.) A later study in Oregon and California sent out 136,000 kits, and a large proportion were Medicaid recipients.

Through this easier testing, and encouraging people to get screened regularly after age 50, “Kaiser Permanente has nearly doubled screening rates — from 43 percent in 2004 to 82 percent in 2013.”

How Reliable Is it?
From the Kaiser Permanente website: “The evidence review, funded by the National Institutes of Health, found that the FITs were fairly sensitive. On average, the tests detected 79 percent, or about 4 of 5 cancers with only one round of testing. The tests were also highly specific: on average, 94 percent of people who did not have cancer tested negative with a single FIT.” [Bold and italics added]

Head to Head: FIT TEST vs. Fecal Blood Samples
A previous at-home test called the fecal occult blood test (also known as FOBT) requires three samples. It detects only about 13-50 percent of cancers.

Dr. Colorado’s interest in equal opportunity to health care arose from her own modest upbringing as the intelligent daughter of a former farm worker and immigrant. She first saw a dentist at age 16. After accepting her, Stanford University called to follow up after she let the enrollment deadline pass. She eventually attend Stanford, among other education institutions. Her bilingual Spanish skills greatly helped her with her research projects. (Read more about Dr. Colorado’s history, Kaiser Permanente researcher)

The video below tells more about the FIT test (no gross stuff – just 2 girls talking naturally about colon care. What?! Your kid doesn’t do that??)

 

Other Colon Cancer Screening Methods in a Handy Chart: Weigh Benefits of Each
***Colon Cancer Screening Methods Chart with Benefits, Risks, Preparation

Most Common Cancers from the American Cancer Society
“Among men, prostate, lung, and colon cancer will account for 44% of all newly diagnosed cancers in 2016, with prostate cancer alone accounting for about 1 in 5 cases.

Among women, the 3 most common cancers in 2016 will be breast, lung, and colon, which together will account for about half of all cases. Breast cancer alone is expected to account for 29% of all new cancer cases among women.” Source link   [I detest the words “will account” here, as if we cannot prevent it and do better.]

And Good News: Cancer Death Rate Falls 23% Over Last 21 Years
“…the death rate from cancer in the US has declined steadily over the past 2 decades. The cancer death rate for men and women combined fell 23% from its peak in 1991 to 2012, the most recent year for which data is available, translating to more than 1.7 million deaths averted during this time period.” [From American Cancer Society website]

Article source information: 

  • http://centerfortotalhealth.org/tag/fit-test/
  • http://share.kaiserpermanente.org/article/simple-at-home-test-will-detect-most-colorectal-cancers/
  • See more at: http://share.kaiserpermanente.org/article/simple-at-home-test-will-detect-most-colorectal-cancers/#sthash.JlChzDfk.dpuf
  • Dr. Colorado’s early history and the FIT test studies: https://research.kpchr.org/News/News-Archive/Post/1084/From-Humble-Roots-CHR-Researcher-Works-to-Prevent-Colon-Cancer-Among-Diverse-Populations
  • American Cancer Society:  http://www.cancer.org/cancer/news/news/cancer-statistics-report-death-rate-down-23-percent-in-21-years
  • Free/Low Cost Colonoscopies:  http://coloncancer.about.com/od/additionalresources/f/Can-I-Get-A-Colonoscopy-Without-Health-Insurance.htm?utm_term=cost%20for%20a%20colonoscopy&utm_content=p1-main-1-title&utm_medium=sem&utm_source=msn&utm_campaign=adid-cf469a07-8898-41bd-b3a1-f050442f0335-0-ab_msb_ocode-28800&ad=semD&an=msn_s&am=broad&q=cost%20for%20a%20colonoscopy&dqi=&o=28800&l=sem&qsrc=999&askid=cf469a07-8898-41bd-b3a1-f050442f0335-0-ab_msb
  • http://www.ccalliance.org/get-screened/prevention-and-screening/
  • Response rates for mailing: personal friend in advertising


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