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Blood test for colon cancer screening approved by US regulators

61 points by Anon84 2y ago

deleted 2y ago
[deleted]
epmatsw 2y ago
I’m really excited for the possibilities liquid biopsies like this introduce. I look forward to when I can get these in an annual physical without having to pay out of pocket and/or jump through a bunch of hoops
melling 2y ago
“The test missed 17% of cancers, performance that is on par with stool-based tests.” I took a stool-based test about 6 years ago and passed. Yesterday I got back from surgery to remove a colon tumor that was discovered about 3 weeks ago. Colon tumors usually take several years to grow. I recommend making the time to get a colonoscopy because small polyps are removed at that time. Once they grow, it’s surgery then possibly 6 months of chemotherapy. Many colon tumors show no symptoms. On a side note, my tumor was making me anemic and my Apple Watch was telling me my Cardio Fitness was decreasing, which wasn’t physically noticeable on my walks until recently.
- everybodyknows 2y ago
  > stool-based test about 6 years ago Current guidance is to repeat the test every year.
  - melling 2y ago
    How early can it detect colon cancer? The thing is avoiding surgery requires catching the tumor when it’s a small polyp. You get chemotherapy if your tumor reaches a lymph node. I think the tests are great but the colonoscopy was a breeze compared to what comes after you find a tumor. These tests can be taken before colonoscopies are recommended Also, for some reason colon cancer is increasing in young people so definitely use these tests but still get that colonoscopy when the time comes. https://www.yalemedicine.org/news/colorectal-cancer-in-young-people https://www.yalemedicine.org/news/colorectal-cancer-in-young...
- stubish 2y ago
  Australia offers stool tests (fecal occult blood test) every 2 years starting at 45. The increased frequency may help. But yes, you can't ignore other symptoms and I hadn't realized the false-negative rate was that high. Hope you have seen the last of your cancer!
  - shiroiushi 2y ago
    Here in Japan, stool tests are done every year at that age as part of the required health check.
- bamboozled 2y ago
  These wearables have a crazy amount of potential when it comes to health. It's phenomenal you had this extra data point
- vibrio 2y ago
  I wish you clean margins and a speedy recovery. The Cardio fitness tracking change is interesting. Is that the VO2 max? By how much did it change over what time frame? Had the clinician(s) seen or heard of that before?
  - melling 2y ago
    Yes, it’s VO2 max. Don’t want to give my numbers but I reached low ability. I’m mainly a walker. The hills started to get difficult. I had a persistent cough that never went away after a winter cold, and shortness of breath. Now think the cough was actually caused by iron deficiency but I’m not a doctor. Went to an ENT, pulmonologist, and GI before we tracked down the issue. No one bought into the Apple Watch numbers. I researched it on the Internet and no one really knows how it’s calculated. It could have been any number of issues. I’ll add being anemic to the possibilities.
- theGnuMe 2y ago
  What apple watch do you have? Also wishing you an uneventful and speedy recovery.
  - melling 2y ago
    The latest model from last fall.
billy99k 2y ago
This looks like it barely detects pre-cancerous growths, so it's pretty much too late by the time it finds something, as it's already turned into cancer.
- nradov 2y ago
  What do you mean by "too late"? It's much easier to treat a small tumor than a large one.
  - tjpnz 2y ago
    How often do you plan on getting the test?
  - billy99k 2y ago
    It's already turned into cancer by the time it's detected in most cases with this test, which could be too late. My brother died of colon cancer at 42 because they found a tumor and couldn't operate due to its location. Colonoscopies, while unpleasant, have come a long way. I get one very 5 years and they have removed pre-cancerous growths.
stubish 2y ago
Does anyone know the detection rate of this blood test when combined with a FOBT stool test?
ggm 2y ago
Not to disparage a test of equal veracity, but this test demands a blood sample. The stool test is swipe two sticks through your crap on a flushable paper sheet in a toilet, seal, and post. The stool test is well understood and ships out worldwide. Maybe there are concerns about preservation of the sample, postal thermal chain issues, but this one, it means a bill. It's probably similar back-end cost but to the patient or health fund, this one costs more. Why is a blood test which is at best as accurate as a stool test "better" to use?
- shiroiushi 2y ago
  A blood test seems like it's much more reliable and simpler, because you don't have to rely on the patient to do it. You already need to get a blood sample for your annual health check anyway, so it's pretty easy to just add yet another test to the battery of tests they're doing with that blood draw. Stool and urine samples are just extra work for the patient to do, and to make sure they're done.
  - ggm 2y ago
    Good point. So this test will fold into the standard bloods battery, and it's cost amortizes out against annual tests.
  - AlbertCory 2y ago
    Those are concerns for a doctor and his/her set of patients. For you, if you're willing to do the stool test, then there's no difference. Right?
    - shiroiushi 2y ago
      I don't follow: I am the patient. For me, a blood test is simpler, because there's absolutely nothing for me to do. A stool test requires me to find not one, but two times before I go to the clinic when I need to poop, and to then go through the task of collecting samples from those poops. (The annual stool test requires 2 samples from two separate BMs.) A blood test literally means absolutely no work or extra time, because I'm already getting a blood draw done at the clinic anyway. It's going to be the same for every patient. The clinic doesn't have to worry about patients forgetting to bring their stool samples, forgetting to do both of them before their appointment, doing them poorly (getting a bad or insufficient sample), etc. The clinic can control everything much better since the blood draw and the handling of the samples is entirely under their control.
tsoukase 2y ago
Blood tests for abnormal circulating cells are a method of future. For example a blood sample test of a pregnant woman can detect many genetic abnormalities and sex of the fetus. It is based on minimal amount of DNA that can be reliably traced. The same can theoretically be done for cancerous cells if their DNA can be distinctly identified.
- _ihaque 2y ago
  These are tests of circulating cell-free DNA (cfDNA), not circulating cells. The fraction of circulating _cancer cells_ is too low (outside of blood cancers or metastatic cancers) to be technically feasible to detect; ditto in pregnancy. By contrast, while there isn't much cfDNA (DNA fragments floating around in blood plasma outside of cells) -- on the order of 1-10 ng/mL -- there's enough to extract reliably, and critically, the fraction of that that is tumor-derived (or fetally-derived, for prenatal testing) can be high. It's already high single to low double digit percent at 10-12 weeks of gestation, and can go much higher in some cancers. But the biggest challenge for these tests is that this "tumor fraction" can be very very low in early stage cancers, which is why stage I sensitivity tends to be quite poor.
  - tsoukase 2y ago
    There is long time to go until a useful "cancer biomarker", sadly. Cancer is a stubborn problem.

61 points by Anon84 2y ago

deleted 2y ago

[deleted]

I’m really excited for the possibilities liquid biopsies like this introduce. I look forward to when I can get these in an annual physical without having to pay out of pocket and/or jump through a bunch of hoops

melling 2y ago

“The test missed 17% of cancers, performance that is on par with stool-based tests.” I took a stool-based test about 6 years ago and passed. Yesterday I got back from surgery to remove a colon tumor that was discovered about 3 weeks ago. Colon tumors usually take several years to grow. I recommend making the time to get a colonoscopy because small polyps are removed at that time. Once they grow, it’s surgery then possibly 6 months of chemotherapy. Many colon tumors show no symptoms. On a side note, my tumor was making me anemic and my Apple Watch was telling me my Cardio Fitness was decreasing, which wasn’t physically noticeable on my walks until recently.

everybodyknows 2y ago
> stool-based test about 6 years ago Current guidance is to repeat the test every year.
- melling 2y ago
  How early can it detect colon cancer? The thing is avoiding surgery requires catching the tumor when it’s a small polyp. You get chemotherapy if your tumor reaches a lymph node. I think the tests are great but the colonoscopy was a breeze compared to what comes after you find a tumor. These tests can be taken before colonoscopies are recommended Also, for some reason colon cancer is increasing in young people so definitely use these tests but still get that colonoscopy when the time comes. https://www.yalemedicine.org/news/colorectal-cancer-in-young-people https://www.yalemedicine.org/news/colorectal-cancer-in-young...
stubish 2y ago
Australia offers stool tests (fecal occult blood test) every 2 years starting at 45. The increased frequency may help. But yes, you can't ignore other symptoms and I hadn't realized the false-negative rate was that high. Hope you have seen the last of your cancer!
- shiroiushi 2y ago
  Here in Japan, stool tests are done every year at that age as part of the required health check.
bamboozled 2y ago
These wearables have a crazy amount of potential when it comes to health. It's phenomenal you had this extra data point
vibrio 2y ago
I wish you clean margins and a speedy recovery. The Cardio fitness tracking change is interesting. Is that the VO2 max? By how much did it change over what time frame? Had the clinician(s) seen or heard of that before?
- melling 2y ago
  Yes, it’s VO2 max. Don’t want to give my numbers but I reached low ability. I’m mainly a walker. The hills started to get difficult. I had a persistent cough that never went away after a winter cold, and shortness of breath. Now think the cough was actually caused by iron deficiency but I’m not a doctor. Went to an ENT, pulmonologist, and GI before we tracked down the issue. No one bought into the Apple Watch numbers. I researched it on the Internet and no one really knows how it’s calculated. It could have been any number of issues. I’ll add being anemic to the possibilities.
theGnuMe 2y ago
What apple watch do you have? Also wishing you an uneventful and speedy recovery.
- melling 2y ago
  The latest model from last fall.

billy99k 2y ago

This looks like it barely detects pre-cancerous growths, so it's pretty much too late by the time it finds something, as it's already turned into cancer.

nradov 2y ago
What do you mean by "too late"? It's much easier to treat a small tumor than a large one.
- tjpnz 2y ago
  How often do you plan on getting the test?
- billy99k 2y ago
  It's already turned into cancer by the time it's detected in most cases with this test, which could be too late. My brother died of colon cancer at 42 because they found a tumor and couldn't operate due to its location. Colonoscopies, while unpleasant, have come a long way. I get one very 5 years and they have removed pre-cancerous growths.

stubish 2y ago

Does anyone know the detection rate of this blood test when combined with a FOBT stool test?

ggm 2y ago

Not to disparage a test of equal veracity, but this test demands a blood sample. The stool test is swipe two sticks through your crap on a flushable paper sheet in a toilet, seal, and post. The stool test is well understood and ships out worldwide. Maybe there are concerns about preservation of the sample, postal thermal chain issues, but this one, it means a bill. It's probably similar back-end cost but to the patient or health fund, this one costs more. Why is a blood test which is at best as accurate as a stool test "better" to use?

shiroiushi 2y ago
A blood test seems like it's much more reliable and simpler, because you don't have to rely on the patient to do it. You already need to get a blood sample for your annual health check anyway, so it's pretty easy to just add yet another test to the battery of tests they're doing with that blood draw. Stool and urine samples are just extra work for the patient to do, and to make sure they're done.
- ggm 2y ago
  Good point. So this test will fold into the standard bloods battery, and it's cost amortizes out against annual tests.
- AlbertCory 2y ago
  Those are concerns for a doctor and his/her set of patients. For you, if you're willing to do the stool test, then there's no difference. Right?
  - shiroiushi 2y ago
    I don't follow: I am the patient. For me, a blood test is simpler, because there's absolutely nothing for me to do. A stool test requires me to find not one, but two times before I go to the clinic when I need to poop, and to then go through the task of collecting samples from those poops. (The annual stool test requires 2 samples from two separate BMs.) A blood test literally means absolutely no work or extra time, because I'm already getting a blood draw done at the clinic anyway. It's going to be the same for every patient. The clinic doesn't have to worry about patients forgetting to bring their stool samples, forgetting to do both of them before their appointment, doing them poorly (getting a bad or insufficient sample), etc. The clinic can control everything much better since the blood draw and the handling of the samples is entirely under their control.

tsoukase 2y ago

Blood tests for abnormal circulating cells are a method of future. For example a blood sample test of a pregnant woman can detect many genetic abnormalities and sex of the fetus. It is based on minimal amount of DNA that can be reliably traced. The same can theoretically be done for cancerous cells if their DNA can be distinctly identified.

_ihaque 2y ago
These are tests of circulating cell-free DNA (cfDNA), not circulating cells. The fraction of circulating _cancer cells_ is too low (outside of blood cancers or metastatic cancers) to be technically feasible to detect; ditto in pregnancy. By contrast, while there isn't much cfDNA (DNA fragments floating around in blood plasma outside of cells) -- on the order of 1-10 ng/mL -- there's enough to extract reliably, and critically, the fraction of that that is tumor-derived (or fetally-derived, for prenatal testing) can be high. It's already high single to low double digit percent at 10-12 weeks of gestation, and can go much higher in some cancers. But the biggest challenge for these tests is that this "tumor fraction" can be very very low in early stage cancers, which is why stage I sensitivity tends to be quite poor.
- tsoukase 2y ago
  There is long time to go until a useful "cancer biomarker", sadly. Cancer is a stubborn problem.