Noninvasive colon cancer screening promising for African Americans

WASHINGTON, DC—A new noninvasive technology for colon cancer screening is a promising alternative to colonoscopy for African Americans. This study was presented at Digestive Disease Week 2015.

Although all men and women are at risk for colon cancer, African Americans are at a higher risk for the disease than other populations. Routine screening tests are recommended for everyone starting at age 50 years; but colon cancer is diagnosed in African Americans at a younger average age than other people, therefore, some experts suggest that African Americans should begin screening at age 45 years.

This study recruited patients to compare the effectiveness of stool DNA (sDNA) testing with colonoscopy for detecting large colon polyps in a first-of-its-kind clinical trial. sDNA is a test that detects colon cancer in its earliest stages, based on analysis of stool DNA. The test is recommended by the American Cancer Society.

“Colon cancer is the second leading cause of cancer deaths in the United States but is a preventable disease,” said Gregory Cooper, MD, co-program leader for Cancer Prevention, UH Seidman Cancer Center, and professor, Case Western Reserve University School of Medicine. “Early detection through screening can prevent the development of colon cancer. This promising new test has the potential to improve colon cancer screening rates and decrease mortality from this deadly disease.”

This study used data from 460 participants for sDNA and 476 participants using fecal immunochemical testing (FIT), also a noninvasive screening test. A little more than one-third of the participants were African American.

According to the results, sDNA sensitivity and specificity of advanced lesions and all adenomas (polyps) in African Americans was similar to or exceeded that of other racial groups, and in some respects, more sensitive than FIT.

“Given the known racial disparities in colonoscopies between African Americans and other racial groups, this noninvasive technology may offer a promising screening alternative,” said Cooper.

Colonoscopy is considered the gold standard for screening because of its ability to not only locate but remove precancerous polyps. All adults older than 50 years should undergo colonoscopy, with certain risk factors for screening at an earlier age. However, many adults do not follow these national guidelines. Evidence indicates that African Americans are less likely than whites to undergo screening tests for colorectal cancer.

“Colonoscopy is truly the best test but it has its limitations and is vastly underused by the public,” said Cooper. “sDNA is emerging as a promising alternative for patients who do not want to undergo colonoscopy or do not have access to the procedure. It also can be beneficial for patients during the years in between colonoscopies.”

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