Though it claimed the lives of more than 50,000 Americans in 2010 alone, colon cancer is actually a largely preventable disease when people adhere to the recommended screening guidelines. According to the U.S. Preventive Services Task Force, there are three methods to choose from: either a colonoscopy performed about every ten years, a flexible sigmoidoscopy every five years, or an annual fecal occult blood test (FOBT) which can be performed at home.
Although FOBT was long considered somewhat inferior to a colonoscopy, a newer version of it called immunochemical FOBT (iFOBT) is proving to be a marked improvement over older versions. The new test has 90 percent specificity for colon cancer and a false-positive rate of about 10 percent. Those were the results found in a study of 2,800 adults led by Dr. Yi-Chia Lee of the National Taiwan University Hospital and published in the Canadian Medical Association Journal.
However, iFOBT alone is far from a perfect diagnostic. Colonoscopies, unlike iFOBT, allow physicians not only to spot, but also to remove pre-cancerous growths called polyps so that they are therapeutic as well as diagnostic tools.
While acknowledging the improved diagnostic power of iFOBT, ACSH s Dr. Elizabeth Whelan is still convinced that undergoing a colonoscopy is a patient s best weapon against colon cancer. I understand that some people may be afraid of the procedure, she says, but it s so easy to prevent colon cancer and eliminate premature deaths by making sure that, if you re over the age of 50 or have risk factors, you get a colonoscopy as recommended by your physician.
ACSH's Dr. Gilbert Ross does point out, however, that compared to a colonoscopy, which can cost up to $3,000, an iFOBT runs only $30, so that an iFOBT is still indeed a valuable clinical tool. It may not be super sensitive or specific, he says, but if your regular annual iFOBT results are negative, you don t necessarily have to get a colonoscopy. And despite it s hassle, says Dr. Ross, a colonoscopy still remains the gold standard for colon cancer diagnosis and therapy.