Increasing Number of Test Options Will Encourage Greater Participation in Colorectal Cancer Screening: GlobalData

Despite being one of the leading causes of death across the world, close to one-third of people in the US do not partake in recommended colorectal cancer (CRC) screening plans aimed at preventing the disease. However, the scenario is gradually changing with the advent of various new tests. Increasing the number of testing options will encourage greater participation to either prevent CRC or detect the disease early when it is most treatable, says leading data and analytics company GlobalData. CRC is the third most common cancer occurring in men and the second most common cancer in women. In addition to inflicting devastating personal costs on patients, CRC places a sizable economic burden on national healthcare systems. For average-risk individuals between the ages of 50–75 years, many governments, cancer societies and organizations recommend routine CRC screening. Options for CRC screening include stool- or feces-based tests performed every one to three years, or procedures such as colonoscopy performed every 10 years.

However, recent estimates project that just 67.3 percent of eligible US adults were up-to-date on their CRC screenings in 2016. Alison Casey, PhD, Medical Device Analyst at GlobalData, says: “Traditionally, colonoscopy is considered to be the most accurate method for early detection of CRC. Despite this, studies suggest that compared to colonoscopy, the uptake of feces tests is often better, possibly due to the easy-to-use and non-invasive nature of such tests.” Currently, in vitro feces tests such as the Guaiac Fecal Occult Blood Test (gFOBT) and Fecal Immunochemical Test (FIT), and a new type of feces test – Cologuard are available in the market. gFOBT and FIT detect small quantities of hidden blood in patient stool. Of the two, studies suggest that FIT is the more sensitive and thus more popular assay. On the other hand, Cologuard detects specific gene mutations and changes in DNA methylation known to be associated with CRC. In addition to Cologuard, another non-invasive test, which measures the methylation status of the Septin 9 gene in blood samples, was also approved by the FDA in 2016 for CRC screening.

Casey concludes: “Physician opinion is currently divided on which test to recommend, as Cologuard and FIT (or gFOBT) offer distinct advantages and disadvantages. In average-risk individuals, the Cologuard, multi-target DNA test is more sensitive than FIT at detecting both CRC (92.3 percent versus 73.8 percent) and advanced precancerous lesions (42.4 percent versus 23.8 percent). However, the Cologuard test also generated more false positive results compared to FIT. Additionally, the Cologuard test needs to be taken less frequently than the gFOBT or FIT tests, but is currently significantly more expensive. “Importantly, Medicare and most major US healthcare insurers now cover Cologuard. Earlier this year, the test’s manufacturer, Exact Sciences, announced that Cologuard has now been used to screen over one million patients. These sales figures, coupled with a strong advertising campaign and celebrity endorsements, indicate that Cologuard, and hopefully CRC screening in general, is currently gaining momentum.” – Medical Buyer Bureau