What is a Colorectal Cancer
Most colorectal cancers start as a growth on the inner lining of the colon or rectum called polyps.
Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common.
Polyps
If a polyp is larger than 1 cm, there are more than 2 polyps, or if dysplasia is seen in the polyp after it's removed, polyps are more likely to contain cancer.
Dysplasia is another pre-cancerous condition. It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they don't look like true cancer cells.
How it Spreads
If cancer forms in a polyp, it can grow into the wall of the colon or rectum over time. The wall of the colon and rectum is made up of many layers. Colorectal cancer starts in the innermost layer (the mucosa) and can grow outward through some or all of the other layers.
When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). From there, they can travel to nearby lymph nodes or to distant parts of the body. The stage (extent of spread) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread outside the colon or rectum.
Colorectal cancer is a cancer that starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colon cancer and rectal cancer are often grouped together because they have many features in common.
Polyps
If a polyp is larger than 1 cm, there are more than 2 polyps, or if dysplasia is seen in the polyp after it's removed, polyps are more likely to contain cancer.
Dysplasia is another pre-cancerous condition. It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they don't look like true cancer cells.
How it Spreads
If cancer forms in a polyp, it can grow into the wall of the colon or rectum over time. The wall of the colon and rectum is made up of many layers. Colorectal cancer starts in the innermost layer (the mucosa) and can grow outward through some or all of the other layers.
When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). From there, they can travel to nearby lymph nodes or to distant parts of the body. The stage (extent of spread) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread outside the colon or rectum.
Colorectal Screening Methods
1. Stool Tests: guiak Fecal Occult Blood Tests (gFOBT), Fecal Immunohistochemistry test (FIT)
2. Colonoscopy
3. Virtual Colonoscopy
4. Cologaurd Test
2. Colonoscopy
3. Virtual Colonoscopy
4. Cologaurd Test
https://www.cologuardtest.com/faq
HOW TO GET SCREENED WITH COLOGUARD
How can I get screened with Cologuard? Who prescribes this test?
Cologuard is available by prescription only and must be ordered by your healthcare provider. Typically, you would discuss screening with your primary care physician, nurse practitioner, physician assistant or other healthcare provider as part of a regular wellness appointment. Cologuard cannot be purchased over the counter. If your healthcare provider would like to know more about Cologuard, please have them contact Exact Sciences Laboratories at 1-844-870-8870.
Is Cologuard available in all U.S. states?
Cologuard was approved by the FDA on August 11, 2014, and is available in all U.S. states. As of October 9, 2014, Exact Sciences Laboratories is licensed in New York state. If you have more specific questions, please contact us at 1-844-870-8870.
ABOUT COLOGUARD & STOOL DNA TECHNOLOGY
What is Cologuard?Cologuard is an easy to use, noninvasive colon cancer screening test that you can use in the privacy of your own home. It identifies altered DNA and/or blood in stool, which are associated with the possibility of colon cancer or precancer. Your healthcare provider will talk with you about your results.
How do you get DNA out of stool?DNA is continuously shed from cells in the intestinal lining, where it is passed into the stool. If cancer or precancer is present, abnormal cells will shed into the colon and stool along with normal cells. We use a molecular biology process to capture specific pieces of DNA for further analysis.
Why does Cologuard use stool samples and not blood samples?DNA is continuously shed from cells in the intestinal lining and passed into the stool. Both precancer and cancer shed DNA, so it can be an early indicator of the presence of colon cancer or precancerous lesions, before altered DNA would be present in the blood stream.
Is Cologuard a genetic test?No. Cologuard is not a test to confirm or deny a suspected genetic condition, or help determine a person's chance of developing or passing on colon cancer. Cologuard does not provide information about DNA changes that are inherited or can be passed on to your children. Cologuard identifies DNA mutations that are acquired over time in cells lining the colon; these mutations can be associated with the presence of colon cancer or precancerous lesions.
How was Cologuard developed?Cologuard was developed by Exact Sciences in collaboration with researchers at the Mayo Foundation for Medical Education and Research. It went through extensive research and development, including a clinical study of 10,000 average risk study participants that validated the test's safety and efficacy in screening for colon cancer and precancer.
Is Cologuard FDA approved?Yes, Cologuard was approved by the FDA in August 2014 after undergoing a rigorous review process known as a Pre-Market Approval (or PMA).
How effective is Cologuard?In a clinical study of 10,000 participants ages 50 -84 years old, of average risk for colon cancer, Cologuard found 92% of cancer. Cologuard was negative in 87% of participants without cancer or advanced precancerous lesions.
Should colonoscopy be used in addition to Cologuard?Cologuard is a screening test. Any positive result should be discussed with your healthcare provider and followed by a diagnostic colonoscopy.
How often should Cologuard be used?The American Cancer Society (ACS) includes multi-target stool DNA (Cologuard) as one of the CRC screening options for average risk adults ages 45 and older. ACS recommends Cologuard every 3 years.
Colon cancer screening guideline recommendations vary for people under the age of 50 and over the age of 75. The decision to screen people over the age of 75 should be made in consultation with a healthcare provider. The rate of false positive Cologuard results increases with age. Talk to your healthcare provider about what screening program is appropriate for you.
Is Cologuard included in the United States Preventive Services Task Force (USPSTF) guidelines? What does this mean?Yes, Cologuard is included in the United States Preventive Services Task Force (USPSTF) guidelines on colon cancer screening as of its June 2016 update. The USPSTF strongly recommends colon cancer screening for people aged 50-75 (‘A’ rating), meaning the committee finds a substantial net benefit in colon cancer screening.
Cologuard is included on equal standing among the other 'A rated' colon cancer screening options, including colonoscopy, CT colonography, flexible sigmoidoscopy, flexible sigmoidoscopy with FIT, gFOBT, and FIT. Read the USPSTF’s guidance on colon cancer screening in full by visiting its website.
Is Cologuard included in the Healthcare Effectiveness Data and Information Set (HEDIS) quality measures? Why does this matter?Yes, stool DNA (i.e. Cologuard) is one of the methods permitted as part of the National Committee for Quality Assurance’s (NCQA) Healthcare Effectiveness Data and Information Set* (HEDIS®) quality measure for colon cancer screening. HEDIS is a helpful tool used by more than 90% of health plans in America. The quality measures analyze the performance of healthcare services and care. The data and results are used to make improvements in the healthcare provider's quality of care and service.
Who can get screened with Cologuard?If you are 45 and older and at average risk for colon cancer, Cologuard may be right for you. Cologuard is not for everyone. It is not a replacement for diagnostic or surveillance colonoscopy in high risk individuals. It may not be right for you if:
- You have a personal history of colon cancer, adenomas or other related cancers
- You have a family history of colon cancer (one or more first degree relatives diagnosed with colon or rectal cancer before the age of 60, or two or more first degree relatives diagnosed with colon or rectal cancer of any age)
- You have had a positive result from another screening method in the last six months
- You have been diagnosed with a condition that places you at high risk for colon cancer. These include but are not limited to: Inflammatory Bowel Disease, Chronic ulcerative colitis, Crohn’s disease, Familial adenomatous polyposis
- You have been diagnosed with a relevant cancer syndrome passed on from your family, such as Hereditary non-polyposis colorectal cancer syndrome, Peutz-Jeghers Syndrome, MYH-Associated Polyposis, Gardner’s syndrome, Turcot’s (or Crail’s) syndrome, Cowden’s syndrome, Juvenile Polyposis, Cronkhite-Canada syndrome, Neurofibromatosis, or Familial Hyperplastic Polyposis
- Results should be interpreted with caution for individuals over age 75, as the rate of false positives increases with age
If one of my family members had colon cancer, is this test right for me?Cologuard is approved for use by adults 45 years of age and older, who are at average risk for colon cancer. It may not be right for you if you have a family history of colon cancer (one or more first degree relatives diagnosed with colon or rectal cancer before the age of 60, or two or more first degree relatives diagnosed with colon or rectal cancer of any age). Please discuss your overall screening plan with your healthcare provider to determine what is right for you.
Can I use Cologuard if I have hemorrhoids, menstrual period or blood in the stool?Cologuard should not be used by those who have or may have blood in their stool due to actively bleeding hemorrhoids, menstruation, or other existing conditions, as this may result in a false positive result. Please discuss your overall screening plan with your healthcare provider to determine what is right for you.
If I have mobility issues, will I have a problem with the test?Collecting a sample for Cologuard involves sitting on a toilet and having a bowel movement, as well as opening bottles and containers. If you typically need assistance using the bathroom or opening containers, you may need assistance while collecting the sample.
PREPARING FOR THE TEST
Do I need to do anything to prepare for this test?Please carefully read the instructions that arrived with the Cologuard Collection Kit prior to collecting the sample. No other special preparation is required.
Do I need to stop taking any medications prior to using the test?No, there is no need to stop any medications prior to collecting a sample for Cologuard.
Are there any dietary restrictions for this test?No, there are no known dietary issues or restrictions that would interfere with an accurate Cologuard result.
References
https://visualsonline.cancer.gov/details.cfm?imageid=11941
https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html%E2%80%8B
https://www.cancer.net/cancer-types/colorectal-cancer/screening
https://commons.m.wikimedia.org/wiki/File:Colorectal_Cancer_Screening_in_the_US_2008.png
https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html%E2%80%8B
https://www.cancer.net/cancer-types/colorectal-cancer/screening
https://commons.m.wikimedia.org/wiki/File:Colorectal_Cancer_Screening_in_the_US_2008.png