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VIDEO: Stool-based colon cancer tests may be effective between scheduled colonoscopies

SAN DIEGO — In this exclusive video from Digestive Disease Week, John B. Kisiel, MD, a gastroenterologist at the Mayo Clinic, discusses the results of two studies that involved stool-based testing for the detection of colon cancer.

“We have ... shown that the way that our endoscopists behave when they have a patient that they know the Cologuard test is positive, it is pretty striking,” Kisiel told Healio Gastroenterology and Liver Disease. “Almost all of the endoscopists experienced an enrichment in their polyp detection, but some of the endoscopists had more than a doubling or even a tripling of their rates of detecting serrated precursor lesions, which are harder for us to find. We think that there is an increase in the post-test likelihood of finding a precancer but also that it is influencing the individual endoscopist behavior. They're looking longer and they're finding more things.”

Additionally, Kisiel highlighted results that assessed the efficacy of the use of stool-based testing as an interval between colonoscopies.

“We also have a group of patients that got stool DNA testing before they were actually do for their next colonoscopy and in that group, the rate at which we found advanced adenomas was strikingly high. We think that this is not only representing the possibility that we may have missed lesions in these patients in the past, but also starts to lend some traction to the idea of using stool DNA testing as an interval exam between colonoscopies and that’s going to correspond well with national data showing that colonoscopy’s protective benefit may not last out until 10 years and bringing patients in earlier for a minimally invasive test may have additional clinical benefit.” – by Ryan McDonald

Reference:

Ebner D, et al. Sa1042. Presented at: Digestive Disease Week 2019; May 18-21; San Diego, California.

Eckmann J, et al. Tu1015. Presented at: Digestive Disease Week 2019; May 18-21; San Diego, California.

Disclosure: Kisiel reports receiving research/grant support from Exact Sciences.

SAN DIEGO — In this exclusive video from Digestive Disease Week, John B. Kisiel, MD, a gastroenterologist at the Mayo Clinic, discusses the results of two studies that involved stool-based testing for the detection of colon cancer.

“We have ... shown that the way that our endoscopists behave when they have a patient that they know the Cologuard test is positive, it is pretty striking,” Kisiel told Healio Gastroenterology and Liver Disease. “Almost all of the endoscopists experienced an enrichment in their polyp detection, but some of the endoscopists had more than a doubling or even a tripling of their rates of detecting serrated precursor lesions, which are harder for us to find. We think that there is an increase in the post-test likelihood of finding a precancer but also that it is influencing the individual endoscopist behavior. They're looking longer and they're finding more things.”

Additionally, Kisiel highlighted results that assessed the efficacy of the use of stool-based testing as an interval between colonoscopies.

“We also have a group of patients that got stool DNA testing before they were actually do for their next colonoscopy and in that group, the rate at which we found advanced adenomas was strikingly high. We think that this is not only representing the possibility that we may have missed lesions in these patients in the past, but also starts to lend some traction to the idea of using stool DNA testing as an interval exam between colonoscopies and that’s going to correspond well with national data showing that colonoscopy’s protective benefit may not last out until 10 years and bringing patients in earlier for a minimally invasive test may have additional clinical benefit.” – by Ryan McDonald

Reference:

Ebner D, et al. Sa1042. Presented at: Digestive Disease Week 2019; May 18-21; San Diego, California.

Eckmann J, et al. Tu1015. Presented at: Digestive Disease Week 2019; May 18-21; San Diego, California.

Disclosure: Kisiel reports receiving research/grant support from Exact Sciences.

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