Patients are often reluctant to undergo colonoscopy. [iStock/Wicki58]
Patient having a colon polyp removed. A flexible telescope (colonoscope) gets passed up the rectum into the lower bowel (colon). The polyp is snared with a hot wire and can be removed whole through the colonoscope. The surgeon is working the instrument using a control, the patient is under general anesthesia. Surgeon and assistant medical technician following progress on monitor. Selective focus.

Colorectal cancer is the second-leading cause of death (behind only lung cancer) among men and women in the United States; 49,700 people are expected to die from the disease this year alone.

National screening guidelines call for men and women at average risk for the disease to begin screening at age 50. Unfortunately, while physicians are eager to get their patients screened, 23 million Americans in this age group who are at average risk do not get screened as recommended. As a result, many people are diagnosed in later stages when treatment is difficult and survival rates low.

The challenge for physicians is that, historically, the screening options they could offer patients were limited and often undesirable, making it a challenge to motivate patients to follow through.

Colonoscopy is the standard procedure used to screen for colorectal cancer, and while it’s an effective option, some patients are unwilling to undergo the procedure because it often involves unpleasant preparation, sedation, and time off work.

Additional lab-based tests, such as the fecal occult blood test (FOBT) and fecal immunochemical test (FIT), were developed to help meet the need for noninvasive options and are designed to detect occult blood in the stool. However, because there are unrelated conditions that can cause blood in the stool, and not all polyps or lesions bleed, these tests may not be reliable on their own for the detection of colorectal cancer. In addition, the FOBT has a long list of potential causes for false positive results and a low level of sensitivity, while FIT delivers only a moderate level of sensitivity.

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