Screening for colorectal cancer by checking for blood in the stool, despite its low cost and ease of use, may not be as effective as a traditional colonoscopy, a University of Colorado Cancer Center doctor argues in a new editorial.
"Testing for blood in the stool can find cancer and advanced adenomas, but it does not work well for finding most adenomas, therefore creates many missed opportunities for cancer prevention," said Dr. Tim Byers, associate director for prevention and control at the cancer center and professor of epidemiology at the Colorado School of Public Health.
A study in the journal Cancer Prevention Research showed that fecal immunochemical testing (FIT), since all colorectal cancers lead to bleeding, is accurate, affordable and can be a useful method of screening underserved populations. But according to Byers, since blood may not be present until after the cancer has progressed, the window for effective treatment may already be closed.
"Tests designed to identify occult blood in the stool are better for detecting colorectal cancer, whereas direct endoscopic visualization of the colorectum [colonoscopy] is better for prevention," Byers writes.
Byers says that if doctors do use the FIT method, they should perform the test every year instead of every five to ten years as with colonoscopies, allowing for treatment to begin sooner. But Byers said relying on FIT may end up costing insurance companies more money in the end if cancers are not detected early.
Byers' editorial appeared in the October issue of Cancer Prevention Research.
