A research team from the University Hospitals (UH) Case Medical Center Seidman Cancer Center and Case Western Reserve University School of Medicine recently discovered that a novel non-invasive method for screening colon cancer can be used as an alternative to the traditional colonoscopy for African Americans. The study wanted to compare the efficacy of a stool DNA (sDNA) test using colonoscopy for identification of large polyps in the colon.
Based on the analysis of stool DNA, colon cancer can be detected in its early stages. The test was developed by a team led by Sanford Markowitz, MD, PhD, oncologist with UH Seidman Cancer Center and Professor of Medicine at Case Western Reserve University School of Medicine.
“Colon cancer is the second leading cause of cancer deaths in the United States but is a preventable disease,” said Gregory Cooper, MD, Co-Program Leader for Cancer Prevention, UH Seidman Cancer Center and Professor, Case Western Reserve University School of Medicine. “Early detection through screening can prevent the development of colon cancer. This promising new test has the potential to improve colon cancer screening rates and decrease mortality from this deadly disease.”
In the study, which was recently presented during the Digestive Disease Week, Dr. Cooper and his co-workers examined data from 460 patients for sDNA and 476 patients using a test named fecal immunochemical testing (FIT). Importantly, about a third of the participants were from an African American background.
Results showed that the test specificity and sensitivity to detect advanced lesions in the colon and all adenomas (polyps) was identical or exceeded among participants from an African American background and other racial groups, and even more sensitive in comparison to FIT.
“Given the known racial disparities in colonoscopies between African Americans and other racial groups, this noninvasive technology may offer a promising screening alternative,” said Dr. Cooper in the news release.
Colonoscopy is the most used screening test for colon cancer since it removes polyps at the same it locates them. It is recommended that all adults aged over 50 years should undergo a colonoscopy and individuals with particular risk factors should be screened at an even earlier age. Nevertheless, results from this new study showed that not all people are being screened for colorectal cancer, particularly individuals from an African-American background.
Previous studies indicate that African-Americans are at a higher risk for colorectal cancer when compared to other populations, and because of this, researchers believe that these individuals should begin their screening at the age of 45.
“Colonoscopy is truly the best test but it has its limitations and is vastly underused by the public,” said Dr. Cooper, who was the clinical Primary Investigator for the study. “SDNA is emerging as a promising alternative for patients who do not want to undergo colonoscopy or do not have access to the procedure. It also can be beneficial for patients during the years in between colonoscopies.”
In their research, Dr. Markowitz and his team found that methylation of the vimentin gene, a particular change in DNA, plays a role in the development of colorectal cancer. Based on these facts, the team developed methods for sensitively detecting this change.
The investigation is being sponsored with a $11.3 million grant from the National Cancer Institute’s Specialized Program of Research Excellence (SPORE) in Gastrointestinal (GI) Cancers award to Case Western Reserve University School of Medicine. The purpose of the research is to reduce the deaths and incidence of colon and esophagus cancers, with the sDNA test now licenced by EXACT Sciences Corporation.
“Among our guiding principles is to pursue and implement breakthrough medical advancements and practices to deliver superior clinical outcomes for our patients,” said Stanton Gerson, MD, Director, UH Seidman Cancer Center and Case Comprehensive Cancer Center, Case Western Reserve University. “Non-invasive sDNA screening is an exciting example of this principle in action and potentially can have a dramatic impact on increasing screening rates and decreasing mortality.”