New Information About Early Colon Cancer Detection

The Centers for Disease Control and Prevention reports that colon cancer is the fourth most common cancer among American adults and the fourth leading cause of cancer death in the United States. What is one of the most important prognostic determinants? Early detection.

“Early-stage colorectal cancer is often curable with surgery alone with no need for chemotherapy or radiation,” said naturopathic oncologist Tina Kaczor, ND, FABNO. “Finding colon cancer at stage I or as a precancerous lesion is always the goal.”

Research demonstrates that colonoscopy is the gold standard in colon cancer screening because it can reduce colon cancer mortality by 68 percent. Yet, statistics indicate that more than 30 percent of adults are not up to date with their colonoscopy screening for a variety of reasons.

“Certainly, the time and effort to have a colonoscopy can be a barrier, as well as the fact that people who work full-time often need to miss work, which can have financial implications and can be inconvenient,” explained Dr. Kaczor who is the co-host of the popular podcast, The Cancer Pod. “However, it’s important that patients understand that colonoscopies are the best at identifying precancerous lesions, finding incidental conditions such as diverticulosis, and providing the patient an overall sense of their ongoing colon cancer risk.”

Of course, colonoscopy is not the only screening tool available. New research shows that at-home fecal immunochemical tests (FIT) can lower the risk of dying from colon cancer.

Are FIT Tests a Good Fit?

The recently published nested case-control study featured 10,711 screening eligible participants who completed one or more FIT screenings in a five-year period. The researchers found that FIT screening was associated with a 33 percent lower risk of colon cancer death and a 42 percent lower risk of cancer in the left colon and rectum.

“While this new study is interesting, it doesn’t provide a complete picture because it only looks at mortality and does not address stage, which is key with early detection and improved prognosis,” said Dr. Kaczor. “Colonoscopy is far superior for detection with a sensitivity of 97.7 percent and a specificity of 99.8 percent, whereas FIT misses almost 30 percent of stage I cancers.”

She explains that research indicates that FIT is better at finding colon cancer after stage II, which is not ideal.

“FIT is now being combined with stool-based DNA testing which improves both sensitivity and specificity, but colonoscopy remains the only tool that achieves screening and risk reduction all in one,” concluded Dr. Kaczor.

There is also now a new blood test that has been approved for colon cancer screening.

New Blood Test Recently Approved

The Shield blood test has become the first blood test approved by the FDA to be used for primary colon cancer screening. The blood test also meets the colon cancer screening requirements for Medicare coverage.

“While the blood test may be more convenient and have increased compliance,” said Dr. Kaczor, “it does not pick up precancerous lesions, which is something that colonoscopies do well.”

The Shield test is a simple blood draw that can be done annually prescribed by a primary care physician. Results from a study published earlier this year showed that the Shield test had 83 percent sensitivity for detecting colon cancer and a 90 percent specificity for uncovering advanced cancers.

An Integrative Approach to Colon Cancer Prevention

In addition to educating patients about the various screening tools available to help prevent colon cancer or detect it early, Dr. Kaczor utilizes an integrative approach that includes diet and lifestyle advice.

“By far the most well-evidenced lifestyle measure to prevent colorectal cancer is movement,” explained Dr. Kaczor. “We have several decades of data showing that exercise reduces colorectal cancer risk and more recently data showing that being sedentary increases risk.”

The other foundational recommendation she focuses on with her patients is increasing soluble and insoluble dietary fiber. “Fiber has been shown to directly lower colon cancer incidence and some soluble fibers also act as food for good bacteria in the colon which go on to produce compounds like butyrate that support colon health,” she explained.

An integrative approach to colon health combines a consistent screening plan along with diet and lifestyle recommendations. While all the screening methods have pros and cons, it’s important to work with each patient to come up with a proactive plan that they can stick with.