New Study May Advocate Stool DNA Testing with Colonoscopy

Doctor-scientists of the Case Western Reserve University School of Medicine and the University Hospitals (UH) Case Medical Center’s Seldman Cancer Center are currently taking on new clinical trials aimed at improving methods of screening for colon cancer. The clinical trial will involve study and research for a new non-invasive procedure for screening colon cancer. This is a 5-year study which would assess the usefulness of stool DNA (sDNA) testing against colonoscopy for detecting large colon polyps in the bowels. The study team is now recruiting people to be part of the research.

New sDNA testing has backing from the American Cancer Society as a sound method of screening for cancer. It can detect colon cancer at an early stage using stool DNA. The method was developed by Stanford Markowitz, an oncologist with a PhD from the UH Seidman Cancer Center. Markowitz is also a Professor at the Case Western Reserve University School of Medicine. Results of the clinical trial could potentially put sDNA alongside colonoscopy as the gold standard of recommended screening methods for detecting early-stage colorectal cancer.

Colon cancer is the second-most leading cause of cancer deaths in the United States, but the fatal cases of the condition can be prevented with proper screening. Dr. Gregory Cooper, another Professor at Case Western Reserve University School of Medicine and Co-Program Leader for Cancer Prevention at UH Seidman Cancer Center, attested to the importance of screening for colon cancer early because if caught at an early stage gastroenterologists can actually prevent the cancer from developing and metastasizing. Cooper said that he believes the new sDNA test has a lot of promise and potential to get more patients screened for colon cancer and, eventually, reduce the number of instances in which colon cancer leads to death.

As of now, the colonoscopy procedure is the best way to screen for colorectal cancer. With a colonoscopy, a gastroenterologist can pinpoint the location of precancerous polyps and actually remove them during the exam, before they have a chance to turn cancerous. Colonoscopy is recommended 1 time every 10 years once a low-risk adult reaches the age of 50. Higher risk patients may need to be screened more frequently starting at age 40 or 45. But, unfortunately, most people do not follow the screening recommendations even after being referred by a primary care provider and those who develop cancer then have to deal with more invasive and incapacitating cancer treatment options such as chemotherapy and strong prescription drugs.

As a screening test, colonoscopy is not without its limitations. It is not fool proof by any means and can indeed miss small or flat polyps. In addition, since most people hesitate to make an appointment for colonoscopy, the test is widely undervalued and has a limited ability to help unwilling patients. Many experts said that what the gastroenterology field needs is to give patients more screening options other than colonoscopy. The new sDNA test method is a purely non-invasive technique that may be able to support screening with the colonoscopy test. Stool DNA testing may be an alternative to those who do not want to undergo colonoscopy before they know cancer is present or those who may lack access to the colonoscopy procedure. Stool DNA testing can also be used in between colonoscopies, as follow-up screenings that can be performed more often.

Dr. Markowitz and his team of researchers played a great role in the development of this new colon cancer screening with sDNA testing. The team came across a specific DNA mutation called methylation of the vimentin gene, which can be detected through DNA testing when a person is diagnosed with colon cancer. After their discovery they created a technique for detecting the DNA change in stool. Their process has been licensed by the EXACT Sciences Corporation for commercial purposes and has been expanded to include a larger scope of gene panels.

Availability of this new sDNA technique has the potential to help in the detection of colon cancer without traditional colonoscopy. However, in order to remove the precancerous polyps from the body and remove physical risk, the more invasive colonoscopy procedure will have to be performed. It is the hope of researchers that more people will undergo screening with stool DNA testing before it becomes too late, so that polyp removal can occur before a full blown cancer develops. Experts estimate that the non-invasive method will be more appreciated by those who fear potential discomfort associated with having a colonoscopy done, including discomfort associated with necessary bowel prep the day before a colonoscopy.

Recent years have seen a general decline in cases of colon cancer as compared to previous years. Many believe that improved rates of screening have been felt due to vigilant campaigning all over the nation in support of raising awareness of why early screening is so important. To make an appointment for a routine colonoscopy procedure, please do not hesitate to find a local gastroenterologist listed in our medical directory.