Dr. Pradeep Kumar was recently interviewed for a Becker’s ASC Review article about the colon cancer screening test, Cologuard. He shed some very important light about the testing methods for the second leading cancer killer in the U.S.
You can read the entire article here, but here’s what Dr. Kumar had to say:
“Colon cancer is the second leading cause of cancer deaths in the U.S. It can be prevented … because colon cancer almost always arises from precancerous polyps that take years to develop into cancer. By finding and removing precancerous polyps, we can prevent colon cancer.
So far, the best way to find precancerous polyps is to perform screening colonoscopy on asymptomatic individuals beginning at age 50 (45 for African-Americans). The dilemma is that at least 40 percent of people eligible to be screened do not get screened. The reasons are numerous, including costs of time and money, access to care, not being aware of screening recommendations and, frankly, just not wanting to have a colonoscopy.
It is the last group of patients for which Cologuard is suited. For people who just do not want to get a colonoscopy, knowing that it can prevent colon cancer, Cologuard is an option. According to their website — which will convey their data in the most favorable terms – Cologuard has a 42 percent high-risk polyp detection rate. These are the most dangerous polyps, which have the greatest chance of developing into colon cancer, and 42 percent is much better than nothing.
So, I would recommend Cologuard to those who insist on not getting a colonoscopy. However, I would not recommend it for any other group. If the issue is time and money, I would discuss those constraints in the context of the cost of getting colon cancer. If it is access to care, whatever test they have access [to] should get performed. If it is not being aware of screening recommendations, I would make them aware. Only for those who know and still don’t want a colonoscopy would I advocate for Cologuard. If the detection rate of dangerous polyps is 42 percent, what is left unsaid is that 58 percent of the most dangerous polyps are not detected by Cologuard, and that is unacceptable.
