If you’ve ever experienced the discomfort of a colonoscopy, you’re not alone in hoping for alternatives.
And while colonoscopies are a critical tool for detecting colorectal cancer (CRC), especially for those of us over 50, there’s some good news on the horizon: a new noninvasive test could reduce the need for frequent colonoscopies by up to 41 percent!
For years, doctors have relied on colonoscopies to monitor patients who’ve had polyps removed during previous procedures—a practice called post-polypectomy surveillance.
But new research suggests that a molecular stool test could offer an effective alternative, reducing the need for invasive procedures while still keeping us safe from CRC.
The Future of Colonoscopies
The latest study, led by researchers in the Netherlands and published in Gastroenterology, tested the effectiveness of two stool-based screening options: the multitarget stool DNA test and fecal immunochemical testing (FIT).
These tests, which analyze stool samples for signs of cancer or precancerous lesions, could replace some colonoscopies, potentially reducing the number of these procedures by 15 percent to 41 percent.
Imagine that—fewer colonoscopies and a simple, noninvasive test instead!
Of course, regular screening is still vital. The multitarget stool DNA test and FIT both detect signs of colorectal cancer, but researchers found that annual FIT surveillance (especially at certain thresholds) had the greatest potential to reduce colonoscopies without compromising safety.
How Does It Work?
Colonoscopies, while effective, can be an uncomfortable experience. They’re invasive, time-consuming, and for some patients, a source of anxiety.
The alternative? Multitarget stool DNA tests or FIT, which allow patients to simply submit a stool sample for analysis.
FIT-based surveillance, in particular, has shown a lot of promise. In this Dutch study, it detected advanced polyps and precursor lesions—especially serrated polyps, which are known precursors to cancer—with remarkable accuracy.
Researchers believe that when applied annually, FIT could substantially reduce the need for repeated colonoscopies over a patient’s lifetime.
How Safe Are These Tests?
If you’re wondering whether these noninvasive tests can really keep you as safe as colonoscopies, rest assured that this new research suggests they can.
While colonoscopies are highly effective at catching cancer early, they’re not without risk. Complications, such as perforation of the colon, bleeding, and reactions to anesthesia, can occur.
Noninvasive stool tests, on the other hand, present little to no risk. And while a positive stool test would still warrant a follow-up colonoscopy, it would reduce the overall number of procedures a patient might need.
It’s important to remember that FIT and molecular stool testing are particularly helpful for post-polypectomy surveillance, a scenario where the risk of CRC is lower. The study showed that these tests, when applied at regular intervals, could maintain the same level of safety and accuracy as colonoscopy surveillance, but with fewer procedures overall.
Saving You (and the System) Money
In addition to the health benefits, stool-based surveillance could be a game-changer when it comes to cost.
Colonoscopies are expensive, with the costs adding up for both patients and healthcare systems—especially when they’re performed repeatedly over time. On the other hand, FIT is a low-cost test, and according to the study, its use could actually save money in the long run.
While the multitarget stool DNA test is more expensive than FIT, the savings in reduced colonoscopies could still balance the scales.
While this study is exciting, more research is needed. The next step will be to run a large-scale, real-world clinical trial to confirm these findings and see how they play out over time. We may soon see post-polypectomy surveillance guidelines evolve to include noninvasive tests like FIT, offering patients a simpler, more convenient way to stay healthy.
So, if you’ve been dreading another colonoscopy, take heart—help may be on the way! These advances in molecular stool testing could change the way we screen for colorectal cancer, making it easier, less invasive, and more cost-effective.
And with fewer colonoscopies on the horizon, that’s a win for everyone.
P.S. Are you too old for a colonoscopy? Here’s the answer.
Sources:
Swift, D. (2024, October 21). Molecular Stool Testing Could Cut Post-Polypectomy Colonoscopies by 15%-41%. Medscape. https://www.medscape.com/viewarticle/molecular-stool-testing-could-cut-post-polypectomy-2024a1000j6o
