9 replies to this topic

[katzenjammer]

Check this out: http://www.gutsense....transcript.html

[Athanasios]

There is a test sold by LabCorp that does as good as colonoscopies now (poo in a box type test). The company that developed the test has since made a much better one (sill noninvasive) that can detect way better than colonoscopy and have few false positives. They also found it can detect for all digestive cancers. The weaker version has been add to the AMA list and the stronger version is to be in trials soon (yet already has very good hard data). It is expected to be in market in less than 4 years.

It has been recently found that colonoscopies have big flaws that only allow for 60% or so of the cancers to be found due to flat side cancers.

I only know so much because I am an investor with high familial risk.

Edited by cnorwood, 23 July 2009 - 08:27 PM.

[katzenjammer]

There is a test sold by LabCorp that does as good as colonoscopies now (poo in a box type test). The company that developed the test has since made a much better one (sill noninvasive) that can detect way better than colonoscopy and have few false positives. They also found it can detect for all digestive cancers. The weaker version has been add to the AMA list and the stronger version is to be in trials soon (yet already has very good hard data). It is expected to be in market in less than 4 years.

It has been recently found that colonoscopies have big flaws that only allow for 60% or so of the cancers to be found due to flat side cancers.

I only know so much because I am an investor with high familial risk.

Thanks for that - I have some family risk as well. Can you point me to specific info/sites? Thanks so much.

[Athanasios]

Thanks for that - I have some family risk as well. Can you point me to specific info/sites? Thanks so much.

The company is Exact Sciences. I am not sure how up to date their site is but you can find more by looking up sDNA and the collaborations with the Mayo Clinic. This is a good article that talks about the test available now and the new test:
http://seekingalpha....s-back-on-track

Also some data:

Am J Gastroenterol. 2008 Nov;103(11):2862-70. Epub 2008 Aug 27. Links
A simplified, noninvasive stool DNA test for colorectal cancer detection.

Itzkowitz S, Brand R, Jandorf L, Durkee K, Millholland J, Rabeneck L, Schroy PC 3rd, Sontag S, Johnson D, Markowitz S, Paszat L, Berger BM.
Department of Medicine and Oncological Sciences, Mount Sinai School of Medicine, New York, New York 10029, USA.
BACKGROUND: As a noninvasive colorectal cancer (CRC) screening test, a multi-marker first generation stool DNA (sDNA V 1.0) test is superior to guaiac-based fecal occult blood tests. An improved sDNA assay (version 2), utilizing only two markers, hypermethylated vimentin gene (hV) and a two site DNA integrity assay (DY), demonstrated in a training set (phase 1a) an even higher sensitivity (88%) for CRC with a specificity of 82%. AIM: To validate in an independent set of patients (phase 1b) the sensitivity and specificity of sDNA version 2 for CRC. METHODS: Forty-two patients with CRC and 241 subjects with normal colonoscopy (NC) provided stool samples, to which they immediately added DNA stabilizing buffer, and mailed their specimen to the laboratory. DNA was purified using gel-based capture, and analyzed for hV and DY using methods identical to those previously published. RESULTS: Using the same cutpoints as the 1a training set (N = 162; 40 CRCs, 122 normals), hV demonstrated a higher and DY a slightly lower sensitivity, for a combined sensitivity of hV + DY of 86%. Optimal cutpoints based on the combined phase 1a + 1b dataset (N = 445; 82 CRCs, 363 normals) yielded a CRC sensitivity of 83%. The vast majority of cancers were detected regardless of tumor stage, tumor location, or patient age. Assay specificity in the phase 1b dataset for hV, DY, and hV + DY was 82%, 85%, and 73%, respectively, using the phase 1a cutpoints. Optimal cutpoints based on the combined phase 1a + 1b dataset yield a specificity of 82%. CONCLUSIONS: This study provides validation of a simplified, improved sDNA test that incorporates only two markers and that demonstrates high sensitivity (83%) and specificity (82%) for CRC. Test performance is highly reproducible in a large set of patients. The use of only two markers will make the test easier to perform, reduce the cost, and facilitate distribution to local laboratories

They have since done a little tweaking and have made it better (preservatives with the poo, I think). The worst case is tht they would have to add an additional marker to get even better results but it would up the cost. As far as I am concerned, I would take these over colonoscopy any day.

Yet, I agree with the website that prevention is important and am very active in this area.

Edited by cnorwood, 23 July 2009 - 09:05 PM.

[katzenjammer]

The company is Exact Sciences. I am not sure how up to date their site is but you can find more by looking up sDNA and the collaborations with the Mayo Clinic. This is a good article that talks about the test available now and the new test:
http://seekingalpha....s-back-on-track

Also some data:


They will be adding additional markers to the test that will further increase its ability. I also think that some false positives here are due to the 'non-cancer' group only being verified by colonoscopy which would let some cancers through.

Thanks so much!

I can't seem to find any information comparing Exact Sciences current fecal test with traditional colonoscopy. Have you run across this anywhere? Cheers, ~katz

[Athanasios]

Colonoscopy only has good results on the left side of the colon
http://www.annals.or...nt/full/150/1/1

This is buried within that article:
for older test

Published studies involving patients known to have invasive CRC show that ColoSure has a sensitivity range of 72-77% and a specificity range of 83-94% while the detection rates for general population screening have yet to be determined.

colonoscopy at 60% and Colosure at 72%-77%

Not the best but non-invasive!

and the newer

Adding further value to the Company’s non-invasive sDNA CRC screening IP, the results of a population-based, case–control study published in the medical journal, Annals of Internal Medicine, concluded that colonoscopies may actually prevent 60%-70% of CRC, rather than the previously quoted rate of 90% for the test.

While colonoscopies are still effective at preventing CRC and will continue to be widely recommended and used; the study highlights limitations of the procedure - especially in the detection of flat and right-sided lesions, with the latter accounting for about 40% of all CRC cases.

Sensitivity results of 82% were already published last summer for the Company’s V2 sDNA technology, while the next-generation sDNA test (V3) boasts 92% sensitivity and has shown the potential to detect 86% of precancerous adenomas.

Colonoscopy 60% and sDNA 86%-92%

Looking much better here.

Edited by cnorwood, 23 July 2009 - 09:17 PM.

[niner]

Check this out: http://www.gutsense....transcript.html

I read most of this, and I think the guy is a crank. He makes some major statistical errors and grossly misinterprets some data from the literature. He mixes virtual colonoscopys with real ones, along with ancient fecal occult blood tests in a bizarre mashup to support his hatred of attempting to detect colon cancer in any way. He also seems obsessed with Katie Couric...

I had a colonoscopy, and it was way better than I expected. The laxative treatments today are not the horrible ones of yesteryear, and with propofol, you sleep through the whole thing and wake up 45 minutes later. It's no big deal. I know a 47 year old woman with colon cancer. She had a family history (grandmother) and now she really wishes she'd had a colonoscopy at 45. My cousin died of colon cancer at 63; no colonoscopy there either. Now it looks like colonoscopy is no longer the only game in town. The fecal DNA tests that cnorwood brings up are really exciting. I'm hoping that I'll not be having any more colonoscopys as a result of that.

Edited by niner, 23 July 2009 - 09:29 PM.

[katzenjammer]

Colonoscopy only has good results on the left side of the colon
http://www.annals.or...nt/full/150/1/1

This is buried within that article:
for older test
colonoscopy at 60% and Colosure at 72%-77%

Not the best but non-invasive!

and the newer


Colonoscopy 60% and sDNA 86%-92%

Looking much better here.

So sDNA may well be the Gold Standard in the coming years. Sounds great!

But even at present it seems that Colosure is preferable (accuracy, comfort, convenience, cost). Why would anyone get a colonoscopy then?

Edited by katzenjammer, 23 July 2009 - 11:39 PM.

[Athanasios]

So sDNA may well be the Gold Standard in the coming years. Sounds great!

But even at present it seems that Colosure is preferable (accuracy, comfort, convenience, cost). Why would anyone get a colonoscopy then?

I hope so!

One upside to colonoscopy is that they can biopsy or remove something if they find it, right then. Lets say you get test results saying you may have cancer w/colosure, you would still need a colonoscopy for removal. That is why some insurers are put off by it and may only offer partial coverage.

With the new test that will come within 4 years, it has a much higher detect rate, so it should be preferred for the increased survival over colonoscopy alone. More insurers will approve of it for full coverage.

[albedo]

A brand new blood test which can replace potentially colonoscopy:

http://www.diagnople...14-02-28_EN.pdf

I went through screening in 2006 and scheduled a new colonoscopy in April. I am going to ask for this new test too.