The article discusses a new blood-based screening test for colon cancer that was recently approved by the FDA. However, experts have raised concerns about the test because it has not been shown to improve mortality rates compared to other screening methods. The test may be more effective at detecting advanced cancers rather than improving outcomes. While the test could increase screening rates by addressing challenges with current methods, doctors need more evidence that it actually reduces colon cancer deaths before widely incorporating it into practice.

1. Cloud over colon cancer
blood test
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2. Contd…
The first-ever bloodbased screening test for detecting colon cancer, recently
approved by the US Food and Drug Administration (US FDA), has come under
the scanner of international public health experts. An article in the medical
journal JAMA (The Journal of the American Medical Association) has raised
concerns about the lack of evidence ensuring clinical use of the test or even
that it improves disease-specific or overall mortality .
“Importantly, no evidence has shown that this new assay improves disease-
specific or overall mortality compared against no screening or against
accepted screening methods,“ the article says.
Questioning the breakthrough test, the article said the ade quacy of the end
point for approval of the test should be questioned. “In contrast with
imaging-based screening, the blood-based screening test for colon cancer
was accepted without demonstrating an improvement in survival for
colorectal cancer,“ it said.
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3. Contd…
Experts say this blood test is more sensitive at detecting advance-stage
cancer and therefore, may not be much useful in improving death rate from
the disease. The JAMA study also empha sizes on the comprehensive role of
physicians in informing patients of the unknown effects of the test on
mortality , the lower rate of detection of precancerous polyps, and the
presence of better alternatives. “Patients should be told that positive test
results commit them to further investigations, likely including endoscopy ,“ it
said.
Multiple alternatives for screening of colorectal cancer are already available
including stool-based tests, such as the fecal occult blood test (FOBT) and
lower endoscopy. However, estimates show around one-fourth of eligible
patients aged 50 to 75 years have never been screened for colon cancer and
half are inadequately tested.
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4. Contd…
This is mainly because of challenges such as handling and storage of
stool samples and so on associated with the existing testing methods.
Stool tests are often also required to be repeated. Moreover, some of
the invasive procedure have limited adherence among patients. The
new blood-based cancer screening is likely to address this gap.
“Yet physicians must question how this newly approved assay might be
incorporated in routine clinical practice, and, most important, whether
use of the test will reduce colorectal cancer mortality ,“ the article said.
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