The colonoscopy has a special place in comedy, but colorectal cancer is no laughing matter. The reality is that a colonoscopy is the best way to detect the second-deadliest type of cancer.

However, fear prompts many people to avoid a colonoscopy. Now, comes a new, less invasive way to screen for colorectal cancer – a new FDA-approved blood test that can be used for people who have an average risk. Dr. Harishankar (Hari) Gopakumar, MD, a gastroenterologist at OSF Medical Group in Bloomington says the new test is aimed at improving the screening rate for colon cancer which currently stands at 63% of all eligible people.

“This blood test could bridge some of gap; that is where I see its main role. If for whatever different reason somebody is not able to get one of the approved colon cancer screenings, other than this latest blood-based test, this could be a bridge to offer some form of screening to them.”

The American Cancer Society says overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. However, each person’s risk might be higher or lower, depending on their risk factors for colorectal cancer, including but not limited to family history.  In people younger than 55 years of age, rates have been increasing by 1% to 2% a year since the mid-1990s, so it’s recommended screening start at 45 years, beginning with a baseline colonoscopy.

The recently approved blood test is easier than the current stool sample option that’s available for people at average risk, but Dr. Gopakumar suggests it is not good for detecting pre-cancerous cells. He says the sensitivity is enough to detect about 13% of pre-cancerous lesions. The success at detecting actual cancer is about the same with the blood test as the stool-based analysis. However, Dr. Gopakumar stresses testing a stool sample offers a better way to detect those early-forming cancer cells and that’s what’s most important.

Detecting colorectal cancer sooner

“Our goal is to be able to pick up these pre-cancerous lesions way before they even have a chance to become cancer and then treat them because at that stage, it’s relatively easy to treat the polyp – you take the polyp out. Nothing after that except maybe a follow up colonoscopy. That is where the difference comes in.”

Currently, about 60–70% of colorectal cancers are diagnosed at an advanced stage. Research suggests if the healthy population regularly submitted to annual screening, the 5-year survival rate could be increased to 73% (currently 65%). So, does Dr. Gopakumar think this new blood test could become part of annual exam testing?

He thinks it could eventually, but not until the test is improved to increase early cancer cell detection.

“This is probably an early stage and with more effective (technology) where we can match the sensitivity and specificity numbers where they detect what we need to detect – close to the stool-based testing or even better than that – then I see this as the future, but it may be a bit further out.”

Dr. Gopakumar says the blood test should not replace the more intensive colonoscopy procedure which, for people with average risk, should be given every 10 years. The FDA recommends getting the blood test every three years starting at age 45 for people not at high risk.

With the various options now available, Dr. Gopakumar recommends having a conversation with your medical provider.

“Make an informed decision so you get the best test that you can and it’s most appropriate for you so you can feel confident you got what you needed done in an appropriate and efficient way.”

The Affordable Care Act (ACA) requires both private insurers and Medicare cover the costs of colorectal cancer screening tests, because these tests are recommended by the United States Preventive Services Task Force (USPSTF). This includes a blood test, but Dr. Gopakumar says check with your insurer and make sure whether prior authorization is needed and to know whether you will have a co-pay.

Video clips with Dr. Hari Gopakumar