Is At-Home Stool Test a Colonoscopy Alternative?


Chronic Lymphocytic Leukemia

By Amy Norton

HealthDay Reporter

MONDAY, Feb. 25, 2019 (HealthDay News) — Simple at-home sofa tests are a arguable approach to shade for colon cancer — and a good choice to invasive colonoscopies, a new investigate examination confirms.

The analysis, of 31 studies, looked during a efficacy of a fecal immunochemical test, or FIT — that detects dark blood in a stool. It found that a one-time FIT screening held adult to 91 percent of colon cancers in people during normal risk of a disease.

Experts pronounced a commentary offer some-more support for a screening exam that has prolonged been a endorsed choice — though not mostly achieved in a United States.

Instead, many Americans are screened for colon cancer by colonoscopy — an invasive exam that examines a colon. However, many other countries preference a yearly sofa test.

“For a average-risk person, there are good alternatives to colonoscopy screening, and people should be wakeful of that,” pronounced Dr. Thomas Imperiale, a comparison researcher on a review. “That’s a bottom line.”

Imperiale is a gastroenterologist with a Indiana University School of Medicine and Regenstrief Institute, in Indianapolis.

He pronounced that in his experience, patients infrequently arrive for a colonoscopy screening carrying never listened about any other options from their primary caring doctor.

“I consider we need to be some-more blunt with patients about all their options,” Imperiale said.

The commentary were reported online Feb. 26 in Annals of Internal Medicine. They’re formed on some-more than 120,000 patients who had FIT screening and a successive colonoscopy.

For a FIT screening, a alloy reserve a exam pack for patients to use during home. Different manufacturers make FITs. Depending on a specific test, a examination found, a one-time screening held around three-quarters to 91 percent of colon cancers.

That creates a one-time FIT reduction supportive than a one-time colonoscopy. But, Imperiale forked out, FIT screening is finished yearly, while colonoscopy is finished each 10 years.

Plus, he said, some people who are not peaceful to bear a colonoscopy competence be OK with a sofa test. And it’s removing screened that matters, Imperiale said.


An editorial published with a investigate points to some tough numbers: Only two-thirds of Americans aged 50 to 75 have been screened for colon cancer, mostly by colonoscopy. Of a one-third who remained unscreened, many are lower-income, uninsured or “underinsured.”

Greater recognition of cheaper, easier FIT screening — among doctors and patients comparison — could assistance tighten that gap, pronounced Dr. James Allison, a editorial author.

For years, Allison said, a media and health systems have promoted colonoscopy screening as a “gold standard” — while FIT is mostly regarded as “second-best.”

But a justification does not support that.

“There is no singular best exam for colon cancer screening,” pronounced Allison, who is with a University of California, San Francisco and a Kaiser Permanente Northern California Division of Research.

And, he forked out, discipline on colon cancer screening do not disciple any one exam over a others.

Guidelines from a U.S. Preventive Services Task Force contend that people during normal risk of colon cancer should start screening during age 50. The American Cancer Society suggests age 45. But both groups contend screening can be finished with sofa tests, colonoscopy or sigmoidoscopy (another invasive test).

Colonoscopies are most improved than FIT during detecting polyps — soft growths that spasmodic spin cancerous. But, Imperiale said, investigate suggests that large, “advanced” polyps transition to cancer during a rate of 3 to 6 percent per year. So if one FIT misses a vast polyp, there’s a good possibility it will still be held during successive tests.

And while colonoscopies are generally safe, they do lift tiny risks of bleeding, infection or bowel tears.

“We need to commend that FIT is during slightest as good as colonoscopy,” Allison said.

There is another form of stool-based screening exam available, called Cologuard. It looks for both dark blood and certain DNA changes that can be found in colon cancers or polyps.

But a exam is costly — around $500 — and there’s no explanation it’s improved than FIT screening, Allison said.

People who select sofa contrast will not indispensably equivocate a colonoscopy. If blood is detected, you’ll need a follow-up colonoscopy — and it might spin out to be a fake alarm. Keeping adult a yearly report is also key, Imperiale said.


SOURCES: Thomas Imperiale, M.D., professor, gastroenterology and hepatology, Indiana University School of Medicine, and investigate scientist, Regenstrief Institute, Indianapolis; James Allison, M.D., clinical highbrow emeritus, medicine, University of California, San Francisco, and investigate scientist emeritus, Kaiser Permanente Northern California Division of Research, Oakland; Feb. 26, 2019,Annals of Internal Medicine, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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