While largely preventable with early detection, less than 40% of Americans seek screening for colorectal cancer.
We’d like to debunk some of the common misconceptions around colorectal cancer as well as bring awareness to our ground-breaking FirstSight test. It’s the first of its kind test for colorectal cancer screening and prevention, offering patients a noninvasive alternative to the colonoscopy. The test detects pre-cancerous cells in blood with 90% accuracy allowing for life saving early detection.
1. Misconception: Cancer is not preventable. A screening test can only detect cancer, it cannot prevent cancer.
This is not true. Until the 1950s, cervical cancer was the top cancer killer for women. Then in the 1950’s Pap smears, which detect pre-cancer, started to be offered to women as part of their routine physical. The widespread adoption of pap smears transformed cervical cancer from one of the top cancer killers for women into a mostly prevented cancer. Mortality from cervical cancer has reduced by 75% in the last 50 years.
2. Misconception: Colorectal cancer is not a problem to our society because we have colonoscopy screening.
Just like cervical cancer, colorectal cancer is preventable. Most colorectal cancer starts as pre-cancers (adenomas) that over time develop into colorectal cancer. If these pre-cancers are detected, they can be removed preventing cancer.
This is why U.S. screening guidelines recommend routine colon cancer screening for 125 million Americans 45 years and older. Yet, 60% of colon cancer is diagnosed after the colorectal cancer has already spread. The survival rates for patients who are diagnosed after the disease has spread to distant organs is 14%.
Colorectal cancer is unfortunately the number 2 cancer killer in the U.S., causing 50,000 deaths annually. The American Cancer Society expects that over 140,000 Americans will be diagnosed with colorectal cancer in 2019.
3. Misconception: Colonoscopy for screening is good enough as a testing option.
Although colonoscopy is very effective for finding and removing pre-cancers, compliance with colonoscopy for screening is less than 40%. This is because it is inconvenient – it is invasive and requires bowel prep.
4. Misconception: I can use home stool tests I see advertised on TV for colon cancer screening.
Indeed, there are home stool tests available for screening. However, consumers should be careful as these stool tests miss 60%-75% of advanced precancers. These have 10-25% probability of becoming cancer.
5. Misconception: I can’t get a blood test for colon cancer screening.
Studies have shown an overwhelming preference among patients for blood testing over colonoscopy and stool tests. Unfortunately, there is no accurate blood test today for the detection of pre-cancer and colorectal cancer.
Not surprisingly then, close to $3 billion has been invested in developing blood tests for early cancer detection, including for colorectal cancer. Most of these technologies analyze DNA fragments in the blood. Others look at epigenetic changes in the blood. However, none of these techniques have been able to detect precancers so far. However, a different approach is showing promise. Pre-cancers and cancers shed cells into the blood. One technology CMx, developed by CellMax Life detects these cells in a single blood sample drawn at the doctor’s office. Results on the performance of the test were recently presented at the American Society of Clinical Oncology’s conference held in San Francisco, in January 2019. The test showed 90% accuracy for detecting pre-cancer and 96% accuracy for colorectal cancer. A larger study is underway in partnership with Stanford, Johns Hopkins and USC Keck School of Medicine. The study is testing thousands of individuals coming in for a routine colonoscopy and the results of the cell-based test will be compared to colonoscopy as the gold- standard.
6. Misconception: I don’t have a family history of colorectal cancer so I don’t really need to get screened.
Only 5% of yearly colon cancer cases in the United States are due to a “cancer gene”. Another 20% of cases occur in people with a family history of the disease, but without a “cancer gene”. This leaves approximately 75% of people who are diagnosed with colon cancer each year for no obvious reason. These are the sporadic colon cancer cases.
7. Misconception: I don’t need to start screening until I am older.
The American Cancer Society in 2018 lowered the age to start screening after a major analysis led by ACS researchers that showed that a beginning screening age of 45 for adults of average risk will result in more lives saved from colorectal cancer. Colorectal cancer incidence has declined steadily over the past two decades in the population aged 50 years and older but there has been about a 51% increase in CRC among those younger than 50 years since 1994. A recent analysis found that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with adults born around 1950, who have the lowest risk.
Note: A more vague term used to describe colorectal cancer is bowel cancer, which describes cancer that starts in either the colon or rectum.