March 29, 2016

Afraid of Colonoscopies? Alternative Noninvasive Tests Are Available but Inaccessible

Colonoscopy. If the word makes you uneasy, you’re far from alone. Unfortunately, aversion to colonoscopies is incredibly common and is preventing many women — who are at high risk for colorectal cancer — from getting the care they need.

Colorectal cancer is the growth of abnormal cancerous cells in the lower part of the colon that connects the anus to the large bowel. Every year, 135,000 people will be diagnosed with colorectal cancer, and 50,000 people will die from it — often due to late-stage diagnosis [1].

Currently, colonoscopies are the most widely utilized screening method for colorectal cancer — but there are other ways. In August 2014, a stool DNA test to screen for colorectal cancer was reviewed and approved through the joint Food and Drug Administration (FDA)-Centers for Medicare & Medicaid Services (CMS) pilot program known as parallel review. The program was intended to help reduce the time between the FDA’s approval of a device and Medicare coverage.

Deemed “safe and effective,” by the FDA, as well as “medically necessary” by the CMS [2], the at-home stool DNA test is a noninvasive, effective alternative to colonoscopies, which are invasive and can seem daunting to many patients. However, the United States Preventive Services Task Force (USPSTF) has failed to issue new screening guidelines in the last eight years — guidelines that must be updated in order to make these screenings more accessible to patients.

As a result, many hospitals and doctors will not offer these tests unless requested, nor will several major insurers cover these new technologies, until the USPSTF updates its guidelines. While the technology exists to allow for noninvasive colorectal cancer screenings — and with it the potential to diagnose earlier, saving lives — our current system needs to better coordinate the inclusion of innovative technologies into the coverage process, improving access for patients.

As dozens of health-related organizations pool their resources to increase the nation’s colon cancer testing rate to 80 percent by the year 2018 [3], it’s more important now than ever before for the USPSTF to update and finalize its outdated colon cancer screening recommendations. Access to these new technologies is critical to advancing care for patients and their providers, as well as achieving better quality outcomes for all.

If you think you may be at increased risk for colorectal cancer, talk to your healthcare provider about when and how often to start screening.

The Society for Women’s Health Research (SWHR) is dedicated to promoting research on biological sex differences in medicine — including the vast sex differences that exist in cancer diagnosis and treatment. Learn more about these differences here, find more resources on colorectal cancer here.