A Less Invasive Way to test for colon Cancer

featured by Florida Today

by Maria Sonnenberg

Dr. Sue Mitra is board certified in international medicine. She is seen here with a Cologuard, which is a noninvasive colon cancer screening test. (Photo by: Tim Shortt/Florida Today)

When Christine Flick’s physician, Dr. Sudeshna Mitra, suggested she undergo colon testing because she was more than 50 years old, the Palm Bay registered nurse, like most people, was not thrilled with the idea.

Because Flick has no family history of colon cancer, Mitra suggested she try Exact Science’s Cologuard test, which is much less invasive than a colonoscopy. Flick agreed.

“The test was easy to do with very simple instructions and very discreet pickup by UPS,” Flick said.

Unfortunately, Flick was not out of the woods yet. Her Cologuard results came back positive and she ended up undergoing a colonoscopy. When they conducted the colonoscpoy, they found a single precancerous polyp that they had to remove.

Cologuard works by looking in the blood and DNA of cells shed in the stool for mutations linked with colorectal cancer. Other stool tests, such as the fecal occult blood test, detect blood in the stool that could indicate cancer or pre-cancerous polyps that could become cancerous down the line, but these tests do not look at DNA.

While reasonably accurate, Cologuard is not intended to replace a diagnostic colonoscopy or surveillance colonoscopy in high-risk individuals. The test is intended for adults 50 years or older at average risk for colorectal cancer.

“Colonoscopy remains the gold standard, but Cologuard is aimed at patients who feel a colonoscopy is too invasive or for whom a colonoscopy is contraindicated because of high risk from anesthesia or other issues,” said Mitra, who practices internal medicine at Medical Associates of Brevard in Melbourne.

“A lot of patients feel a colonoscopy is too aggressive, so they hesitate having it done,” said Mitra.

On the other hand, because it is a simple DNA stool test, Cologuard is easy and noninvasive. The test is performed in the convenience and privacy of home and the sample is sent to the lab via prepaid UPS shipping. In a couple of weeks, your physician receives the test results. That’s all there is to it, so it’s hard for patients to grouse about it.

“I’m very fond of this test,” Mitra said. “It is simple and reliable.”

If a patient for whatever reason is hesitant to undergo a colonoscopy, Cologuard offers a viable alternative to spot possible colorectal cancer, a disease that although highly treatable if detected early through regular screenings, remains the second-leading cause of cancer-related death in the United States.

According to the American Cancer Society, more than 137,000 new cases of colon or rectal cancer are diagnosed annually. The sooner these are detected, the better the survival rates.

Cologuard is the only FDA-approved non-invasive stool DNA screening for colorectal cancer. Usually covered by most insurances, including Medicare, the test is dropped off at your front door, the same as those boxes from Amazon, and you can perform the screening when the time works out best for you.

Cologuard results should be interpreted with caution for individuals over age 75, since the rate of false positive results spikes as the patient ages. Any positive Colorguard test result should be followed by a diagnostic colonoscopy. Following a negative result, patients should continue participating in a screening program as recommended by their physician.

Despite the limitations of Cologuard, the test has caught the eye of the experts. This year, Cologuard won the 10th Annual Prix Galien USA Award for best medical technology product, presented by the Galien Foundation to recognize biomedical and technology product achievement associated with improving the human condition.

Cologuard is also in the recommendations of the U.S. Preventive Services Task Force and the American Cancer Society’s colorectal cancer screening guidelines.

Mitra sees using the test as a way to raise colon cancer screening rates.

“It is a great option,” she said.