MINNEAPOLIS (WCCO) — It’s been one year since Mayo Clinic researchers got the go-ahead on a potential game-changer. A test that people could take at home that screens for the second-most deadly type of cancer: Colon cancer.
The Food and Drug Administration approved Cologuard, and Medicare covers it. It’s a non-invasive way to screen for colon cancer. An alternative to a colonoscopy, it’s an at-home test where users take their own stool sample and mail specimens to a lab.
Researchers say it’s been a successful 12 months Still, most local specialists are not prescribing it.
If you’re lucky, cancer of the colon is only something you’ve only casually heard about. Sarah Debord, 38, lost that naivety four years ago.
“It’s disrupted my whole life, its disrupted the life of my kids, my family, my career, my weekends,” Debord said.
She didn’t even know what malignant meant when her doctor described her tumor. She was a nursing mom, and an avid runner. Didn’t that explain her exhaustion and weight loss? It wasn’t until she was using the restroom 10-20 times a day and passing blood that she got a colonoscopy, her doctor gave her the news.
“He said ‘We couldn’t complete the colonoscopy because there’s a blockage and it looks malignant,'” she said.
Colon cancer is a subject she’s now a virtual expert on.
“I’m four years into actually doing chemo and on a bi-monthly basis and it’s working. It’s keeping me alive,” Debord said.
She works with the Colon Cancer Coalition in between treatments. A coalition she says is celebrating the newest screening tool. Cologuard went on the market last year.
“To be able to have a test that can not only be done in the privacy of your home but can be done quickly and efficiently and not take any time out of your routine, cause you’re gonna go to the bathroom anyway, is just amazing and exciting for people like me to see,” Debord said.
The test was born in southern Minnesota. It took 20 years of research in a Mayo Clinic Lab to make the test a reality, a vision of Dr. David Ahlquist.
“It was a dream come true in many ways, the culmination of so much effort,” Ahlquist said.
Cologuard tests DNA from the bowel for cancer or pre-cancerous polyps. Colonoscopies involve sedation and a two-day cleansing process that makes people shy away.
“Only about half the population, based on record reviews, half are undergoing screening,” Ahlquist said.
He says his Cologuard is quick, private and available to people in remote areas. People who don’t have access to doctors. He says it’s catching on, it’s been prescribed 100,000 times.
“To put in perspective, 100,000 tests would have detected 500 new cancers,” Ahlquist said.
He cites success stories like Chuck Flolo’s. The Apple Valley man’s family physician recommended it since it had been seven years since his last colonoscopy. It came back positive. Surgery revealed a lesion and polyps that were pre-cancerous.
“I get emails and calls multiple times a week from patients or physician telling me their cancer was diagnosed or their large polyps were detected,” Ahlquist said.
Back in the Twin Cities, praise is not universal. Gastroenterologists at Allina and at the University of Minnesota are not prescribing the test. Neither are the doctors at the state’s biggest gastro practice. Dr. Donald Zogg is with Minnesota Gastroenterology.
“About one out of five people are gonna get the wrong answer when they do that test,” Zogg said.
Dr. Donald Zogg is talking about the false positive and negative rate of the test. He says that deters him, as well as the fact most insurance companies don’t yet cover it.
“About $600 for the test and you haven’t actually removed a single polyp,” Zogg said.
He says his team still recommends a colonoscopy because if something’s spotted in that procedure, doctors can remove it right away.
“There’s a lot of miss information out there. This is a disruptive, new technology, and there’s always push back from those who are doing the older, conventional approaches,” Ahlquist said.
Dr. Ahlquist says insurance companies are slow to cover new tests. He feels confident they will wise up.
“Cologuard is equivalent to colonoscopy in terms of detecting early stage cancer,” Ahlquist said.
A statement he says he’s confident of. A statement Sarah Debord supports, too.
“We just want people to get screened in general so the best test is the one that gets done,” Debord said.
More than 70 rounds into chemo, she’s a veteran in a fight she wants no one else to share.
“You could prevent going through everything I’ve been through by taking one day out of your life to take a take-home test or to go get a colonoscopy,’ she said.
And that’s the thing about colon cancer — even though it is so deadly, if it’s caught in stage one or two – it is treatable – that’s why screening is key.
Dr. David Ahlquist says his hope is that Cologuard will open up the door for simple screening tests for pancreatic and liver cancers.