Not very long ago, we highlighted the advent of a new blood test to detect colon cancer. While we made clear its accuracy in detecting early-stage colon cancer is not equal to that of a traditional colonoscopy, for those who have not undergone a colonoscopy or other screening tests, it may provide at least some valuable evidence of your colon and rectal health. As a reminder, colon cancer, the second most common cause of cancer worldwide, is treatable if caught early enough, and can even be prevented through the detection and removal of precancerous polyps. Worrisome signs that should send you to the doctor for investigation? Symptoms might include abdominal discomfort or cramping, rectal bleeding or blood in the stool, unexplained weight loss, or changes in bowel movements. A family history of colon cancer or a prior history of polyps also means you are at greater risk. Lifestyle habits can also put you at risk, including poor diet choices, lack of exercise, alcohol use, smoking, obesity, or being overweight. A recent study published in JAMA Oncology examined whether the use of low-dose or regular aspirin might help reduce the risk of colorectal cancer in individuals at high risk due to poor lifestyle habits. Analyzing 30 years of data with over 100,000 participants, the researchers concluded that those with lifestyle risks, especially smoking and obesity, may be able to lower their risk of this cancer with regular aspirin use. Given that aspirin can cause gastrointestinal bleeding along with other side effects, it’s not recommended you start an aspirin regimen without first checking in with your physician. However, aspirin could be an easy and inexpensive way to cut down colorectal cancer risk among certain populations. So check your medicine cabinet and read here and here for more about this study.

It remains the case with colon cancer that proactive screening is critical to preventing and catching the disease early enough to produce a good outcome. As a review, the screening options run the gamut from the gold standard colonoscopy to virtual colonoscopies, to various at-home stool tests to the aforementioned blood test. As we previously wrote, colonoscopies are the “gold standard,” with accuracy rates close to 95% in detecting cancer and with imagery that allows for the detection and removal of precancerous polyps. Assuming nothing is detected and you are not at high risk, you won’t need another colonoscopy for at least a decade. There are various types of fecal tests, some done annually, and some done every 3 years, with varying levels of accuracy and specificity. For a good review of the options and how they compare, come out of the bathroom and look here.

There is, however, brand new information concerning one of the fecal tests that may influence your decision-making. The FDA has just announced the approval of the next-generation test from Exact Sciences, the makers of Cologuard. As you may remember from our July post, Cologuard is a test that detects both blood and the DNA of cancer cells in stool. It is thought to be the most accurate of the stool tests on the market and only needs to be conducted every 3 years. What the FDA just approved is a newer version of this test, called Cologuard Plus, which has 30% fewer false positives than the previous version of Cologuard (meaning fewer follow-up colonoscopies will be necessary). With a higher level of sensitivity, this new test can detect the presence of colon cancer in 95% of cases and can detect advanced precancerous polyps in 43% of cases. While still not quite the same as a colonoscopy, this level of sensitivity should help to improve the diagnosis of colorectal cancer in our country, especially given the fact that an estimated 60 million adults are not up-to-date with recommended colon cancer screening. The new test should be available in early 2025 and will likely be covered by Medicare and other insurance providers. Find out more about this important new option here and here.