Non-invasive home-based screening reduces risk of colorectal cancer death by 33 percent

Medical News: A groundbreaking study has brought exciting news: a noninvasive colorectal cancer screening test that can be done at home can reduce the risk of colorectal cancer death by an impressive 33%. This Medical News report delves into the details of this revolutionary research and its potential implications for making cancer screening more accessible.


Non-invasive home-based screening reduces risk of colorectal cancer death by 33 percent

Study Overview and Key Findings
Researchers from The Ohio State University Comprehensive Cancer Center -  Arthur G. James Cancer Hospital and the Richard J. Solove Research Institute (OSUCCC - James)-USA, and Kaiser Permanente-USA have provided compelling evidence supporting the efficacy of the fecal immunochemical test (FIT). The study involved nearly 11,000 patients who underwent at-home FIT among Kaiser Permanente’s members in Northern and Southern California between 2002 and 2017. Kaiser Permanente is recognized for having one of the largest at-home screening programs in the United States, emphasizing the importance of increasing overall screening compliance and addressing racial disparity gaps in healthcare.
 
Dr Chyke Doubeni, a leading researcher in this study, stated, "The evidence shows that FIT done every year is as good as getting a colonoscopy every 10 years for screening people of average risk."
 
This simple, noninvasive test can be a game-changer in cancer prevention and is something that everyone at risk should to consider it considering that colorectal cancer is rising at at exponential rate globally.
 
Importance of Accessible Screening
Dr Doubeni highlights a critical point: "The right screening test is the one that gets done - and is done well. Although we have known for decades that colorectal cancer can be caught in its earliest, precancerous state through screening, only about 60% of Americans aged 45-75 years are up to date with screening. This is a tragedy because we could save many more lives by making screening more accessible through non-invasive screening methods like FIT."

Many people avoid getting a colonoscopy due to fear or embarrassment, resulting in late diagnoses and less treatable stages of colorectal cancer. The FIT test offers a solution by being noninvasive and easy to complete at home. A stool sample is collected at home and mailed to a laboratory for testing, eliminating the need for an invasive procedure. This accessibility can significantly increase screening rates and save lives.
 
There are now even second-generation versions of Fit test kits that are sold at drug stores and pharmacies where the test is completely done at home with no need to even send the samples to a lab and results are within minutes.
 
Study Design and Methods
The researchers evaluated information from 10,711 individuals aged 52 to 85 who completed a FIT screening for colorectal cancer. The data was collected from multiple medical centers over a 15-year period. The study found a 33% reduction in colorectal cancer-related deaths and a 42% reduction in left colon and rectal cancers.
 
Effectiveness of FIT: A Closer Look
The study's findings are significant. It revealed that annual FIT screening is just as effective as a decadal colonoscopy for people of average risk. Additionally, the researchers observed a 42% lower risk for cancers occurring on the left side of the colon, including rectal cancers. The test also showed a lower risk of colorectal cancer death among non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White individuals.
 
According to the American Cancer Society, Black patients are 20% more likely to be diagnosed with colon cancer and 40% more likely to die from the disease compared to non-Hispanic White patients. People in the Appalachian region also have disproportionately high rates of death from colorectal cancer. These statistics underscore the importance of accessible screening methods like FIT
 
Dr Douglas Corley, co-principal investigator and chief research officer from Kaiser Permanente, Northern California, stated, "Colorectal cancer screening works and is one of the best ways of decreasing deaths from colorectal cancer. This study confirms that the FIT method is an effective tool. It can be performed at home, and we anticipate that regular, annual use, as recommended, can result in even larger reductions in cancer deaths over time."

Addressing Disparities and Increasing Access
The Wexner Medical Center and the OSUCCC - James have launched a pilot program to provide at-home colorectal cancer screening tests, now offered in primary care clinics. This initiative aims to increase screening rates and reduce disparities in cancer diagnosis and outcomes.
 
The Broader Implications
The significance of this study extends beyond the immediate findings. By proving that a noninvasive, home-based test can be as effective as a colonoscopy, it opens the door to more widespread and regular screening. This could lead to earlier detection and treatment, which is crucial in improving survival rates for colorectal cancer.
 
The FIT test works by detecting hidden blood in the stool, which can be an early sign of cancer. It's simple to use and doesn't require any dietary restrictions or preparation, making it more convenient for patients. By removing barriers to screening, FIT can help ensure that more people get tested regularly.
 
Dr Doubeni emphasized the importance of follow-up procedures, stating, "Anyone with a positive test should not delay getting a colonoscopy to follow up on an abnormal FIT result." A screening colonoscopy involves inserting a thin tube with a camera tip into the rectum to view the intestinal lining, allowing for the removal of precancerous polyps and early treatment of cancers.
 
Expanding At-Home Testing Programs
Programs like the one launched by The Wexner Medical Center and OSUCCC - James are essential in making these tests more available. By providing these tests in primary care clinics and through mail, they make it easier for people to get screened without having to visit a hospital or clinic.
 
This approach can also help address racial and socioeconomic disparities in healthcare. For instance, Black patients and those in rural areas often face higher barriers to accessing healthcare services. By offering a convenient at-home test, these programs can help bridge the gap and ensure that everyone has the opportunity to get screened.
 
The Future of Colorectal Cancer Screening
The findings of this study suggest that at-home FIT screening could revolutionize colorectal cancer prevention, making it more accessible and reducing disparities in healthcare. By offering a simple, noninvasive test that can be done at home, more people may be willing to undergo regular screening, ultimately saving lives. Moreover, the success of FIT screening programs could pave the way for similar approaches to other types of cancer and diseases. As technology and medical research advance, we can expect more innovative solutions that make healthcare more accessible and effective.
 
Final Thoughts
In conclusion, the study conducted by researchers from The Ohio State University and Kaiser Permanente provides strong evidence for the effectiveness of home-based FIT screening in reducing colorectal cancer mortality. This noninvasive test offers a practical and accessible alternative to traditional colonoscopies, making it easier for more people to get screened and potentially saving thousands of lives.
 
The study findings were published in the peer-reviewed journal JAMA Network Open.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821348
 
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