polyps in colon?
polyps in colon?
Noninvasive Test for Colon Cancer Shows Promise in Early Trial
Noninvasive Test for Colon Cancer Shows Promise in Early Trial
Stool-based screen beats current versions, but results must be replicated in larger trials, experts say
A new noninvasive test to detect pre-cancerous polyps and colon tumors appears to be more accurate than current noninvasive tests such as the fecal occult blood test, Mayo clinic researchers say.
The search for a highly accurate, noninvasive alternative to invasive screens such as colonoscopy or sigmoidoscopy is a “Holy Grail” of colon cancer research.
In a preliminary trial, the new test was able to identify 64 percent of pre-cancerous polyps and 85 percent of full-blown cancers, the researchers reported.
Dr. Floriano Marchetti, an assistant professor of clinical surgery in the division of colon and rectal surgery at University of Miami Sylvester Comprehensive Cancer Center, said the new test could be an important adjunct to colon cancer screening if it proves itself in further study.
“Obviously, these findings need to be replicated on a larger scale,” he said. “Hopefully, this is a good start for a more reliable test.”
Dr. Durado Brooks, director of colorectal cancer at the American Cancer Society, agreed. “These findings are interesting,” he said. “They will be more interesting if we ever get this kind of data in a screening population.”
The study’s lead researcher remained optimistic.
“There are 150,000 new cases of colon cancer each year in the United States, treated at an estimated cost of $14 billion,” noted Dr. David A. Ahlquist, professor of medicine and a consultant in gastroenterology at the Mayo Clinic in Rochester, Minn.
“The dream is to eradicate colon cancer altogether and the most realistic approach to getting there is screening,” he said. “And screening not only in a way that would not only detect cancer, but pre-cancer. Our test takes us closer to that dream.”
Ahlquist was scheduled to present the findings of the study Thursday in Philadelphia at a meeting on colorectal cancer sponsored by the American Association for Cancer Research.
The new technology, called the Cologuard sDNA test, works by identifying specific altered DNA in cells shed by pre-cancerous or cancerous polyps into the patient’s stool.
If a DNA abnormality is found, a colonoscopy would still be needed to confirm the results, just as happens now after a positive fecal occult blood test (FOBT) result.
To see whether the test was effective, Ahlquist’s team tried it out on more than 1,100 frozen stool samples from patients with and without colorectal cancer.
The test was able to detect 85.3 percent of colorectal cancers and 63.8 percent of polyps bigger than 1 centimeter. Polyps this size are considered pre-cancers and most likely to progress to cancer, Ahlquist said.
The sensitivity of the test is much better than what has been seen in other stool screening tests, the ACS’ Brooks added. “But, showing that in a small group of samples is very different from demonstrating that in a population where only a small number of individuals are going to have polyps of that size. Then we will know if this is a big step forward,” he said.
According to Ahlquist, Cologuard is the first noninvasive test to detect pre-cancerous polyps, he added.
In addition, the test is the only one that is able to identify cancer in all locations throughout the colon, something which other tests either can’t or don’t do well, Ahlquist said.
One more advantage: patients do not need to do any special preparation before taking the test, something that other tests require, he added.
Ahlquist noted that the test still needs to be refined. “We learned there are still some bugs and we can make the test even better,” he said.
Cologuard is not yet available for sale. Clinical trials comparing the test with colonoscopy are slated to start next year. Ahlquist hopes that the test will be approved and available within two years.
Ahlquist noted that the cost of the test has not yet been established. It is expected to cost more than a fecal occult blood test, but far less than a colonoscopy. A fecal occult blood test can cost as little as $23 while a colonoscopy can total $700.
Another benefit is that it would probably need to be done once every three years; while the fecal occult blood test is usually done yearly. Savings over time on a more accurate test done fewer times could justify the higher cost of the Cologuard test, Ahlquist said.
In two other presentations at the meeting, researchers have linked key gene variants to the risk for colon cancer and also to the prognosis of the disease.
In one study, researchers found that people who have long telomeres, the small strips of DNA that cover the ends of chromosomes, have a 30 percent increased risk of developing colon cancer.
“Even for people their age, their telomeres were longer than you’d expect for healthy people,” lead researcher Dr. Lisa A. Boardman, an associate professor of medicine at the Mayo Clinic, said in a statement. “This suggests that there may be two different mechanisms that affect telomere length and that set up susceptibility to cancer,” she said.
In the other study, a research team led by Kim M. Smits, a molecular biologist and epidemiologist in the GROW-School for Oncology and Developmental Biology at Maastricht University Medical Center in the Netherlands, uncovered a surprise when it came to a gene variant on the KRAS gene called the G variant. This variant, long linked to poorer outcomes in advanced colorectal cancer, actually predicted a better prognosis in early-stage colon cancer.
“You would intuitively think that the G variant would be associated with a poorer prognosis, as it is in late-stage colorectal cancer, but that is not the case,” Smits said in a statement.
Experts point out that studies presented at scientific meetings do not have to pass the rigorous peer review of studies published in reputable journals.
About the Author
SOURCES: David A. Ahlquist, M.D., professor of medicine, Mayo Clinic, Rochester, Minn.; Durado Brooks, MD, director of colorectal cancer,American Cancer Society; Floriano Marchetti, M.D., assistant professor of clinical surgery, Division of Colon and Rectal Surgery, University of Miami Sylvester Comprehensive Cancer Center; Oct. 28, 2010, presentation, 2010 Special Conference for Colorectal Cancer: Biology, American Association for Cancer Research, Philadelphia
Colon Polyps Health Byte
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they can turn cancerous if not removed, its an easy thing to have them removed usually, but you also may have one of those infected, be glad it was caught, my husbands colon exploded while he was at work one day. colon polyps know no age, and yes the diharrea is part of it. good luck.
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polyps can be cancerous but aren't usually, my mother had/has them and the doc told her some people have them and never know as they come and go. she even had some removed, she had a lot way up inside but they weren't cancerous, she gets checked every year and its been over 15 yrs since the last one…no cancer. don't worry, it will be fine…
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Take a deep breath.
I'm a nurse, and according to what you told me, it seems that you have caught things just in time. Not that you don't need to worry, just worry less.
Most polyps when detected early and removed (usually via colonoscopy and sigmoidoscopy) can remove cancer risk.
Having scattered ones does not mean much of anything, as far as increased/decreased risk.
People 35 years old get colon cancer, but it is a little younger than average. If cancer runs in your family, this may explain why.
The diarrhea may or may not be connected. Usually, polyps cause constipation, but some people's bodies work differently, and there's really no way to know anyway.
Good luck!
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polyps can be a sign of cancer, but having them does not mean you will get it. My father has polyps and he has had countless colonoscopies and various treatments of the same vein and the doctors have yet to find cancer. He has had the polyps for over two years. My father's doctor makes him go for more regular check ups. Since cancer does run in your family, make sure you remind your doctor of that fact. They may do additional screening as a precaution, just as they have for my father.
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first off try not to worry.. Polyps are quite common, and can easily be removed.
After they are removed they will send them off to be checked, which is a normal routine.. Any time some is removed from our bodies, its is now always sent off to be checked for cancer.
35 is not too young to get them.
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well we don't know your medical history, but just from what you're saying, you have a high risk for colon cancer
colon cancer is probably the cancer most highly associated with family history, most cancers are not this way–but colon cancer runs in families for sure.
polyps are what are known as 'pre-cancerous' lesions, in that they can become cancerous. Since you said you have many polyps, that also suggests you could be at a much higher risk than normal.
Yes colon cancer can strike the very young. And yes your symptoms warrant you being checked out.
You need a colonoscopy at least once a year (maybe every 9 months), and you need to take care of yourself by getting very close and regimented follow up with a GI doctor, your primary care doctor, and if you eventually would need it, an oncologist
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I've had a colon polyp at age 32, and they are the leading cause of colon cancer if not removed. I had 2 checkups since they found that polyp and thankfully they didn't find any more. I've always had bad problems with my digestive system. I guess it's from having irritable bowel syndrome and never forgoing chocolate or milk products. It's something i can deal with. I am not sure if IBS will cause polyps, or how they form. I just know they don't hurt. They did cause some impaction, but not that bad. That's how i knew i had the one i did.
They wil remove your polyps by putting you under sedation, and snipping them. Then you'll do what i do, go in for an exam two or three times to make sure no more have grown. Your condition is not that serious, providing that you get rid of them. Of course they will take them to the lab after they snip them, to make sure none are cancerous. Sometimes they will be called "pre-cancerous". I'm not really sure what that means, but i guess it means that they could turn into cancer if not taken out. All colon polyps can, so that's kind of a redundant thing for the medical profession to say.
Be thankful that your doctor found them early! Godspeed!!!
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it doesn't matter what your age is with colon cancer. Polyps can certainly turn into cancerous tumors. They really should be removed so you don't worry about them. Blood in the stools is a sign of polyps too. I wonder why they didn't remove them during the scan but good luck to you and you will be just fine. Stay healthy
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