27 Jan Stool DNA Tests (Cologuard ) Increases Colon Cancer Screening and Detection Among Previously Noncompliant Patients
MedicalResearch.com Interview with:
Dr. Mark Prince
Dr. Mark Prince MD
USMD Health System
Arlington, TX 76017
MedicalResearch.com: What is the background for this study?
Response: This 12-month retrospective study conducted to determine the screening compliance rates for a noninvasive multitarget stool DNA (mt-sDNA) screening test (Cologuard) for colon cancer among a cohort of nearly 400 average-risk Medicare patients who had previously not complied with recommended screening. These were patients who had never had a colonoscopy, had been more than ten years since last colonoscopy, or had been more than one year since last stool testing for occult blood.
MedicalResearch.com: What are the main findings?
Response: The study found that when prescribed Cologuard, 88.3% (nearly 9 out of 10 people) who previously avoided other screening measures, including colonoscopy, followed through. Among these patients, Cologuard detected colon cancer in four patients and advanced adenomas or polyps in 21 patients.
Additionally, the study tested whether prescribing Cologuard in a real-life clinical setting would reveal similar results as in the previous New England Journal of Medicine study, published in April 2014. The study yielded very similar results in a population of average risk Medicare patients.
MedicalResearch.com: What should readers take away from your report?
Response: This study highlights an important finding in the area of colorectal cancer screening compliance, an important public health issue. The American Cancer Society and U.S. Preventive Services Task Force recommends adults at average risk for colon cancer begin screening for the disease at age 50. However, data repeatedly have shown that many patients do not get recommended screenings for colon cancer, which is a central reason why this highly preventable and treatable cancer will claim close to 50,000 lives in the U.S. in 2017 alone. According to a separate study published in 2012, only 38% of those prescribed colonoscopy comply. This study shows that when presented with Cologuard as a screening option for colon cancer, patients are significantly more likely to comply and get screened for this largely preventable and highly treatable cancer.
In addition, when told of a positive mt-sDNA result, 96% of patients did get the recommended colonoscopy. This is very encouraging since any positive noninvasive colon screening positive result should be followed up with a colonoscopy.
These patients followed standard medical practices. This was a retrospective study, no navigators or patient study coordinators were involved to get these impressive compliance results. The primary care and gastroenterology clinics just followed routine real life daily scheduling and follow up of results for these patients.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Understanding why so many patients did complete the mt-sDNA when they had been noncompliant with screening in the past deserves further attention. In addition, the high colonoscopy completion rate suggests patients trusted the result of the mt-sDNA. Further studies to determine what patients really thought when given the news of a positive mt-sDNA would be valuable.
MedicalResearch.com: Is there anything else you would like to add?
Response: Increasing colon cancer screening by noninvasive testing or by colonoscopy is needed to further reduce development of colon cancer. Colonoscopy is certainly the best screening method. However, the impressive results of patient acceptance for mt-sDNA suggest noninvasive testing can reach patients who were unscreened or not compliant with screening.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
World J Gastroenterol 2017 January 21; 23(3): 464-471 ISSN 1007-9327 (print) ISSN 2219-2840 (online
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on January 27, 2017 by Marie Benz MD FAAD