colonoscopy

Convenience matters when it comes to healthcare diagnostic tests – the ease of taking the test influences test uptake. It is equally important to consider the efficacy and cost of the test. Now, research has shown that although a newly approved blood-based screening test for colorectal cancer (CRC) would be easy to administer, it fell short in terms of preventing cancer-specific deaths and cost-efficacy.

Timely CRC screening can prevent cancer, and early-stage CRC is treatable. However, timely and regular screening among eligible average-risk populations remains an uphill battle for the clinical community. Colonoscopy is the gold standard for screening, especially because it allows doctors to remove pre-cancerous polyps during the screening process. However, the prep and the need to take time off from work make it challenging from the population’s perspective. There are several stool-based screening options (FIT, FIT-DNA) that seem easier because the patient collects and mails in the sample, but the challenge there is the patient has to take the lead with sample collection and mailing it in.

So, there was excitement when the first blood-based test was approved by the FDA for CRC screening. However, the new study, published in Annals of Internal Medicine, has found that the test does not match up in its ability to meaningfully lower incidence and mortality of CRC compared to colonoscopy or stool test in the average-risk population. According to the authors of the research study, the incremental cost of the cell-free DNA blood test exceeded incremental benefits when the screening interval was reduced to two years or made annual instead of the recommended once every three years. The authors conclude that the test is not as effective at reducing incidence or mortality from CRC as much as colonoscopy or stool-based testing.