About a month ago the FDA a approved the Cologuard a non-invasive colorectal cancer screening test. Sweet right? No more scopes where the sun doesn't shine. I mean let's check out what the media had to say about the Cologuard test.
"Instead of a colonoscopy, which often scares people due to the prep work and the invasive procedure, a stool sample would be checked for the presence of red blood cells and DNA mutations."
http://www.kare11.com/story/news/health/2014/08/11/fda-approves-alternative-to-colonoscopy/13932001/I'm scared no colonoscopy for me...woohooo!!
"A new alternative for one of the most dreaded medical procedures is about to hit the market. Cologuard is the first ever non-invasive colorectal cancer test that can be taken under the privacy of your own home."
http://www.wkow.com/story/26261424/2014/08/12/fda-approves-local-companys-non-invasive-test-for-colon-cancerAn alternative I can do at home...sign me up.
"Alberto Gutierrez, Director of the Office of In Vitro Diagnostics and Radiological Health at FDA’s Center for Devices and Radiological Health, said, “Cologuard gives patients and physicians a better alternative to the painful session of colonoscopy in detecting colon cancer.”"
http://www.wallstreetotc.com/fda-approves-cologuard-test-giving-90-accurate-results-colon-cancer/27097/Even the FDA guy says it's a better alternative.
"Those who would rather avoid having a colonoscopy now have the option of Cologuard, a noninvasive test that detects the presence of red blood cells and DNA mutations that may indicate the presence of certain kinds of abnormal growths."
http://www.cleveland.com/healthfit/index.ssf/2014/08/cwru_uh_researchers_discovery_behind_first_approved_stool_dna_colorectal_cancer_screening_test.htmlI want to avoid cameras where the sun doesn't shine.
"In March, Mayo Clinic announced results of a large clinical trial showing Cologuard was about as effective as a colonoscopy in detecting problems."
http://www.twincities.com/localnews/ci_26317777/mayo-backed-colon-screening-test-gets-fda-approvalAbout as effective...that's all I need.
"Accurate colon cancer screening has usually involved a colonoscopy, an invasive and unpleasant procedure many chose to avoid. But on Monday, the Food and Drug Administration approved the first and only non-invasive stool DNA colorectal cancer screening test from Exact Sciences Corp. (NASDAQ: EXAS)."
http://247wallst.com/investing/2014/08/12/exact-sciences-colon-cancer-screen-fda-approval-a-total-game-changer/It's accurate see they said so, why would I not want to avoid an unpleasant procedure?
Well let me be the first one to break it to you. If you do the cologuard test rather than a colonoscopy you ARE increasing the chance that you'll end up with colon cancer. Period! Now why did I not read that in any of the articles? Are you telling me the media of this nation didn't do their homework? Say it aint' so? I guess you really can't blame the media, I mean it is much easier re-printing press releases than being actual journalists.
Look there may be a place for the Cologuard in the colorectal cancer screening tool box. But, it doesn't replace the colonscopy in the tool box. I'm sorry everyone. It just doesn't.
So, you're probably asking yourself, "I wonder why?" First let's talk about how Cologuard works. Basically you poop in a jar and send it to a lab. That lab then looks through the poop for DNA and blood. The idea is that tumors and even some precancerous polyps slough off both blood and tissue (that contains DNA) into poop as it travels through the colon. The trick? The Cologuard guys have found a way to find it in quantities lower than ever before, so the test is more sensitive to the older fecal based tests.
So, since I'm a numbers guy, let get into that. This paper (http://www.nejm.org/doi/full/10.1056/NEJMoa1311194) was published in the New England Journal of Medicine and it has all of the goods. Let's get down to the bottom line. The Cologuard test has a 92% sensitivity in detecting stage I-IV colon cancers. Well that's pretty damn good, isn't it? I mean nothing is 100%. Yeah 92% is a solid number. So why do I make the comment, "If you do the cologuard test rather than a colonoscopy you ARE increasing the chance that you'll end up with colon cancer. Period!" Well it's pretty simple. While Cologuard is decent at finding cancer, it's mediocre at finding precancerous polyps. Cologuard only found 42% of precancerous lesions found by a colonoscopy. Let me tell you, if you have a choice finding colon cancer before it becomes cancer you should chose that. If they find something and it's cancer, if you're lucky it's just some cutting and sewing. If you're moderately lucky maybe some chemo and radiation. If you're luck is piss poor then it could be something you deal with for the rest of your life. As a guy that's had colon cancer and a polyp removed a few months ago, the treatment for the polyp is infinitely easier than the treatment for cancer.
I feel confident speaking for Colon cancer patients around the world in saying, "Suck it up and get your colonoscopy." Colon cancer is one of the few cancers that can be screened for and prevented given a timely colonoscopy. So, just go do it, they really aren't that bad.
P.S. Shame on the FDA guy for that quote. "Better alternative"? By what metric? Not at finding cancer or polyps, which is the point right?
No comments:
Post a Comment