Wednesday, October 8, 2014

FDA Approves Home Test for Colon Cancer

The FDA has approved a new home test for colon cancer. The new test, called "Cologuard", tests not only for hidden blood in the stool, but also for changes to DNA that may signal the presence of colon cancer.

Current recommendations by the U.S. Preventive Services Task Force for screening for colon cancer are that persons aged 50-75 should have an occult blood test every year and a colonoscopy every 10 years. Whether the Task Force will include Cologuard as an option in future recommendations is unknown. Nor is it clear yet whether Medicare or most insurance companies will pay for the test. That's critical to its acceptance because Cologuard costs nearly $600; much more than the standard occult blood test.

With any test, it's important to consider how accurate the test is. Cologuard appears to be better than the occult blood test at detecting cancers when they are present (92% of cancers detected, versus 74% for the occult blood test). However, Cologuard also has a higher "false positive" rate (reporting that cancer may be present when in fact it is not) of 13% versus 5% for the occult blood test. A positive result with Cologuard should be followed up with a colonoscopy, just to be sure.

Cologuard isn't perfect. But if it is used by people who refuse to go to the doctor for a blood test or especially for a colonoscopy, then it will serve a purpose.

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