Colon cancer test is lauded

By GINA KOLATA

The New York Times

An 18-year study of more than 46,000 people has found that a simple but little-used screening test may help prevent people from getting colon cancer.

The test, known as fecal occult blood screening, looks for traces of blood in a person’s stool, a possible sign of a cancer or benign polyps that can be precursors to cancer. When these polyps are removed, the cancer is prevented. In the study, the colon cancer rate was reduced by as much as 20 percent among people who had the test.

The federally financed study, described in toTday’s issue of The New England Journal of Medicine, was conducted by Dr. Jack Mandel, a vice president of Exponent, a Menlo Park, Calif., research company, and his colleagues.

Dr. Ernest Hawk, chief of the gastrointestinal cancer group at the National Cancer Institute’s division of cancer prevention, said that it was already known the test reduced the colon cancer death rate by allowing cancers to be detected in early stages. But this was the first evidence that those who use the test can avoid colon cancer in the first place.

Hawk said that people whose colon cancer was detected in its earliest stage had a five-year survival rate of 90 percent while those whose cancer is discovered in the latest stage had just an 8 percent survival rate.

"It’s like the ultimate stage shift," Hawk said of the new results. "Not only do you not get stage D cancer, you don’t get cancer at all."

Colon cancer kills 65,000 Americans a year, making it the leading cause of cancer deaths for men and women, after lung cancer. Besides the fecal blood test, doctors detect it by performing colonoscopies, in which a flexible scope is used to examine the entire colon, and sigmoidoscopies, in which a scope is used to examine the lower part of the colon, where most cancers occur. In addition, some doctors look for cancers with barium enemas.

But these tests are uncomfortable as well as being more expensive and elaborate than the fecal test. The fecal test is also the only one that has been shown in rigorous studies to reduce the colon cancer death rate, though doctors are convinced that the other tests have the same effect.

Colon cancers begin as harmless polyps which can be found and removed. Some researchers had long hoped that screening tests could prevent the disease. If so, they said, the testing would offer an unprecedented opportunity to attack a devastating and common cancer.

In the new study, there were 417 cases of the cancer among 15,532 people who were offered annual fecal blood tests; 435 cancer cases among 15,550 people offered the test every other year; and 507 cases among the 15,363 people who did not have the test — a 20 percent reduction in the cancer rate among those who were offered the screening test.

"What we had until now is evidence that early detection reduces the mortality from colon cancer," said Dr. Steven Woolf, a professor of family medicine at Virginia Commonwealth University who wrote an editorial accompanying the new study. "But early detection presumes the cancer already exists. This takes us to a new level."

The study began in 1975, nearly a decade after the fecal occult blood test was discovered but before anyone knew if it was effective in screening for colon cancer.

Their first result was published in 1993, showing that people who had the fecal blood test had a 33 percent reduction in their death rate from colon cancer. Two large European studies subsequently confirmed that result, Mandel said.

Medical experts say that it almost does not matter what test is chosen, as long as people are screened.

But, Mandel and others said, doctors should start urging their patients who are older than 50 to be screened using at least one of the tests.

"We have the means, we have the technology, to virtually eradicate this disease," Mandel said. "To me, that is quite exciting."

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

Ariel Garcia, 4, was last seen Wednesday morning in an apartment in the 4800 block of Vesper Dr. (Photo provided by Everett Police)
How to donate to the family of Ariel Garcia

Everett police believe the boy’s mother, Janet Garcia, stabbed him repeatedly and left his body in Pierce County.

A ribbon is cut during the Orange Line kick off event at the Lynnwood Transit Center on Saturday, March 30, 2024 in Lynnwood, Washington. (Annie Barker / The Herald)
‘A huge year for transit’: Swift Orange Line begins in Lynnwood

Elected officials, community members celebrate Snohomish County’s newest bus rapid transit line.

Bethany Teed, a certified peer counselor with Sunrise Services and experienced hairstylist, cuts the hair of Eli LeFevre during a resource fair at the Carnegie Resource Center on Wednesday, March 6, 2024, in downtown Everett, Washington. (Ryan Berry / The Herald)
Carnegie center is a one-stop shop for housing, work, health — and hope

The resource center in downtown Everett connects people to more than 50 social service programs.

Everett mall renderings from Brixton Capital. (Photo provided by the City of Everett)
Topgolf at the Everett Mall? Mayor’s hint still unconfirmed

After Cassie Franklin’s annual address, rumors circled about what “top” entertainment tenant could be landing at Everett Mall.

Foamy brown water, emanating a smell similar to sewage, runs along the property line of Lisa Jansson’s home after spilling off from the DTG Enterprises property on Tuesday, March 5, 2024, in Snohomish, Washington. Jansson said the water in the small stream had been flowing clean and clear only a few weeks earlier. (Ryan Berry / The Herald)
Neighbors of Maltby recycling facility assert polluted runoff, noise

For years, the DTG facility has operated without proper permits. Residents feel a heavy burden as “watchdogs” holding the company accountable.

Logo for news use featuring the municipality of Stanwood in Snohomish County, Washington. 220118
Stanwood man gets federal prison for selling fentanyl on dark web

In 2013, Christerfer Frick was sentenced to nine years for trafficking drugs. He began selling online upon his release in 2020.

Traffic idles while waiting for the lights to change along 33rd Avenue West on Tuesday, April 2, 2024 in Lynnwood, Washington. (Olivia Vanni / The Herald)
Lynnwood seeks solutions to Costco traffic boondoggle

Let’s take a look at the troublesome intersection of 33rd Avenue W and 30th Place W, as Lynnwood weighs options for better traffic flow.

Dan Templeman speaks during a forum lead by The Daily Herald on housing affordability at the Mukilteo Library on Thursday, April 11, 2024 in Mukilteo, Washington. (Annie Barker / The Herald)
At Herald forum, experts affirm Housing First model, despite downsides

At the Mukilteo Library, panelists discussed drug-contaminated housing and lengthy cleanup efforts in Snohomish County.

Molbak's Garden + Home in Woodinville, Washington closed on Jan. 28 2024. (Photo courtesy of Molbak's)
Molbak’s, former Woodinville garden store, hopes for a comeback

Molbak’s wants to create a “hub” for retailers and community groups at its former Woodinville store. But first it must raise $2.5 million.

A fire at a home near Alderwood Mall sent one neighbor and one firefighter to the hospital. (Photo provided by South County Fire)
Officials: Residents returned to burning Lynnwood home to rescue dogs

Five people and six dogs were displaced in the Thursday afternoon house fire, according to South County Fire.

Featuring a pink blush over a yellow background, WA 64 combines qualities of Honeycrisp and Cripps Pink (aka Pink Lady) for a firm, crisp, sweet and tart bite. A naming contest for the new apple runs through May 5, 2024. (Photo provided by Washington State University)
Hey Honeycrisp, this new breed of apple needs a name

Enter a naming contest for WA 64, a hybrid apple with the same baby daddy as Cosmic Crisp.

Police respond to a wrong way crash Thursday night on Highway 525 in Lynnwood after a police chase. (Photo provided by Washington State Department of Transportation)
Lynnwood woman, 83, killed in wrong-way crash following police pursuit

Deputies said they were chasing a man, 37, south on Highway 525 when he swerved into northbound lanes, killing an oncoming driver.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.