New at-home test offers promising alternative to colonoscopy

There are some things you look forward to: a summer barbecue, a Caribbean cruise. Then there are some you don’t, like an electric bill in August. But then, there are things you absolutely dread. Chief in that last category are invasive medical tests… with colonoscopies at the top of the list for most people.

I get it—they’re not exactly an afternoon in the park. So I have some good news for you.

On Aug. 12, the FDA approved Cologuard, a non-invasive, stool-based, colorectal cancer (CRC) screening test that you can take in the privacy of your own home. Even better? There’s no grueling preparation required.

Cologuard analyzes stool DNA and blood biomarkers that CRC or advanced adenomas shed into the colon.

But let me be clear: it’s not a replacement for colonoscopy. Especially in high-risk individuals, like myself, whose dad and uncle both died of CRC. (Because of that, I go in for a colonoscopy every three years, and I never miss an appointment, not even by a day.) You’ll also still need a colonoscopy to follow up if your results come back positive (which may indicate the presence of CRC or advanced adenoma).

The closest non-invasive test to Cologuard that currently exists is the fecal immunochemical test (FIT), which screens for any microscopic blood cells in your stool. Cologuard takes it a couple steps further. In a large clinical trial, Cologuard detected 92% of colorectal cancers and up to 69% of advanced adenomas (polyps). FIT screening, on the other hand, detected 74% of cancers and 24% of advanced adenomas.

The Centers for Medicare & Medicaid Services (CMS) also issued a proposed national coverage determination for Cologuard, making it the first product to be reviewed through a joint FDA-CMS pilot program. What that means for you is that this new, non-invasive option may soon be covered by Medicare. Which is a bright spot in the otherwise dismal-looking future of medicine.

Proposed coverage for the Cologuard test would be once every 3 years for Medicare beneficiaries, age 50 to 85. I guess you’re on your own after 85.

And, of course, there’s plenty of “fine print” to be aware of. Coverage also depends on your current health status (i.e. no signs or symptoms that might indicate colorectal disease—like gastrointestinal pain or blood in the stool) as well as your risk profile (i.e. no personal history of polyps, colorectal cancer, or inflammatory bowel disease, including Crohn’s disease and ulcerative colitis; and no family history of colorectal cancers or polyps).

Welcome to the greatest health care system in the world, folks.

But don’t let the potential government red tape discourage you. While the Cologuard test—and the coverage for it—is certainly not foolproof, it’s better than inaction. Which makes it a good option for those of you who forego testing of any kind (and believe me, I have many patients like this). This is why it’s so crucial: Sadly, CRC is often found too late, and has already spread. And in these cases, the treatment is grueling and the disease can be fatal.

But if you detect it early enough, CRC can be beaten.

It’s not worth the weight: Excess pounds tied to cancer risk

It’s impossible to talk about cancer screening without bringing up cancer prevention. And, by association, it’s impossible to talk about cancer prevention without broaching the subject of weight. I know this isn’t news to you—or anyone who gets my Reality Health Check or monthly Logical Health Alternatives newsletter. But based on the findings of yet more research, it’s worth bringing up again.

A UK study published by the prestigious medical journal Lancet identified 5.24 million people aged 16 and older, and measured their risk of developing the 22 most common types of cancer according to body mass index, or BMI (after adjusting for individual factors such as age and smoking status).

The results were sobering (though not surprising).

After 7.5 years, 166,955 of the subject developed one of these cancers. And BMI was identified as a risk factor in 17 of them (including thyroid, gallbladder, kidney,  and colon cancers). And in most cases, the study found that the higher the BMI, the greater the risk.

The bottom line: back slowly away from the jelly donut. (A little dark chocolate is OK, though. See, who said I was a dessert buzzkill?)

This study is just further evidence of something I’ve been saying for years: Excess weight is a cancer risk. Plain and simple. But it’s one of the easiest ones to take control of. I’m constantly giving you tips and advice on ways to drop excess weight without torturing yourself. And I’ve also written an in-depth report offering my detailed protocol for keeping cancer at bay.

In other words, there’s absolutely no need to let your BMI determine your fate where cancer is concerned.