As many as one third of Americans may forego a colonoscopy because they consider it embarrassing or uncomfortable. Home stool tests could provide a different type of detection for colorectal cancer.

A study in The New England Journal of Medicine suggests that a new DNA stool test is more accurate than the older fecal immunochemical or FIT stool tests that are commercially available. Comparisons of the DNA test and the FIT test to colonoscopy showed that 154 individuals would need to be screened to detect one cancer with colonoscopy; 166 need to be screened to detect a single colon cancer with the DNA test and 208 individuals would need to be screened with FIT to detect one such cancer.

The bottom line seems to be that newer multi-target DNA stool tests can be helpful in early detection, but colonoscopies remain the gold standard.

[NEJM, March 19, 2014]

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  1. Elizabeth Jones
    Reply

    This test is very good at detecting curable-stage cancers, and the best part is it is done frequently compared to other test which is done annually.

  2. Ellen C.
    Reply

    I don’t think doctors in Dallas, Texas know about the DNA testing for colon cancer yet. Not surprising. I have refused a colonoscopy for several reasons. Among my friends and acquaintances, five who had colonoscopies suffered severe consequences… death for two of them and emergency surgery for three of them. I have a thus-far undiagnosed
    malabsorption problem, gluten sensitivity, and lactose intolerance… a lifetime of GI problems and I take Norvasc; so, I really don’t want to take the “cleanout” prep and risk even worse problems. I have had to make my own peace with the possibility that I may develop a problem that won’t be discovered easily.
    I suffered a cardiac arrest when given dye for kidney x-rays. Four days of levaquin IV produced hallucinations and five different cardiac arrhythmias, one of which I still have eight years later. Peni-strep years ago left me with a penicillin allergy. Xanax gave me four days of agitation and a heart rate that never dropped under 125. I have some kind of neuromuscular problem (bilateral internuclear ophthalmoplegia, urinary incontinence, balance problems, double vision) that seven neurologists, two neuro-ophthalmologists, two endocrinologists, several internists, etc. have been unable to diagnoses. They tell me that it might be MS, but I’m not convinced.
    In short, if anyone wants to know the side effects of a medication, let me take it and I can tell them quickly. Norvasc (the generic doesn’t work) for my blood pressure produced gum overgrowth to the point that I am facing major surgery. It also produced a bleeding disorder.
    I have had a couple of doctors, when we lived in other cities, who were wonderful, curious, knowledgeable people, and my health improved. Now that we are back in Dallas, I have not found such a doctor. Still looking.
    Thanks for your wonderful column. My husband took statins which resulted in neuropathies, muscle pain, and memory loss. He was also on a PPI for ‘way too many years, but, thanks to your information, has gotten off of it. His doctor took one of the statins himself and now he won’t prescribe them for anyone.
    I have to get off the Norvasc before I can have the surgery on my gums and teeth. Hopefully, I can find a good physician who will understand my problems with medications. With so little time to talk to their patients these days, they just write prescriptions for symptoms. Not good medicine.

  3. JAS
    Reply

    I don’t understand the fecal test: What if there’s no blood detected at the time the sample feces is tested? Doesn’t intermittent bleeding happen with colon cancer? This sounds too risky…

  4. MOG
    Reply

    I assume there’s a massive price differential between the DNA test for colon cancer and the colonoscopy. If I am correct in that assumption, why is it still preferable to do the colonoscopy — is the diagnostic advantage THAT statistically significant? Would any such advantage be offset by the greater number of people willing to take the less-yucky, less time-consuming, DNA test?

  5. JN
    Reply

    When will this be coming out? I have not wanted to do the other it is so invasive.
    People’s Pharmacy response: Sorry. We cannot predict when FDA may approve it.

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