GI cancer screening topped headlines in 2023: Did your patients get the message?
Click Here to Manage Email Alerts
From updates in colorectal cancer screening to developments in screening methods, Healio has been at the forefront of coverage for gastrointestinal cancer in 2023 – but has the important news made its way to your patients?
Patients may be particularly interested that CMS has lowered the coverage age for screening colonoscopies from 50 to 45 years and expanded coverage for certain CRC screening tests, just as a flurry of new cancer tests made their way to market alongside promising data for early screening outcomes.
Image: Adobe Stock
In case you missed any of it during the year, Healio recaps the top news in GI cancer you and your patients should be aware of.
CMS lowers CRC screening coverage age, requires new modifier for follow-up colonoscopy
CMS has announced expanded coverage for specific colorectal cancer screening tests by lowering the minimum age to include individuals aged 45 years and older under Medicare Part B.
“CMS is expanding coverage for colonoscopy for all Americans at age 45 instead of age 50. This is a welcome change, as it aligns with evidence-based guidelines by the United States Preventive Services Taskforce,” Shazia Siddique, MD, MSHP, assistant professor of medicine at the University of Pennsylvania and director of research at the Center for Healthcare Improvement and Patient Safety, told Healio. “Thanks to the Affordable Care Act, screening colonoscopies are essentially free for Americans, and now this is extended to Americans between ages 45 to 49 as well.” Read more.
Surveillance colonoscopy ‘may be overutilized’ in older adults with lower life expectancy
Despite a low likelihood of finding advanced polyps or colorectal cancer, more than 85% of older patients with a history of polyps were advised to return for surveillance colonoscopy, regardless of life expectancy or current results.
“We have observed in clinical care that colonoscopy for monitoring in patients with a history of colon polyps is sometimes performed when people are of advanced age and/or when people may not be in the best health due to other medical problems or have competing health priorities,” Audrey H. Calderwood, MD, MS, director of the Comprehensive Gastroenterology Center and associate professor at Geisel School of Medicine and the Dartmouth Institute, told Healio. “Another motivation was the current lack of data to help clinicians and their patients decide on whether or not pursuing another colonoscopy in the context of their overall health is the right decision for them.” Read more.
Patients with rectal cancer report ‘good’ quality of life with watch-and-wait approach
Patients with rectal cancer who were observed by a watch-and-wait approach reported “good” quality of life and less major bowel dysfunction than those requiring surgery, according to study results in JAMA Surgery.
“Patients observed by the watch-and-wait (WW) approach presumably have a better quality of life (QoL) and functional outcome because they do not require a definitive colostomy and have less surgery-related morbidity,” Petra A. Custers, MD, of the department of surgery at the Netherlands Cancer Institute, and colleagues wrote. “A small matched-controlled study revealed that patients observed by the WW approach scored better on several QoL domains and reported fewer bowel, urinary and sexual dysfunctions compared with patients after [total mesorectal excision]. Nevertheless, prospective long-term data on QoL and functional outcome after the WW approach are limited.” Read more.
Sensitivity of next-generation Cologuard in precancer detection ‘numerically exceeded’ FIT
VANCOUVER, British Columbia — A next-generation, multitarget stool DNA test detected colorectal cancer with 94% sensitivity and 91% specificity, outperforming fecal immunochemical testing, according to late-breaking data here.
“The next-generation Cologuard is different from FIT in that it has different markers,” Thomas F. Imperiale, MD, professor of medicine at Indiana University Medical Center, told Healio at the ACG Annual Scientific Meeting. “They’re all methylated DNA markers, as opposed to the current version where there were two methylated DNA markers and mutations in the KRAS gene.” Read more.
Laparoscopic gastrectomy could become ‘standard treatment’ for advanced gastric cancer
Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection was noninferior to open distal gastrectomy in patients with locally advanced gastric cancer, according to 5-year follow-up data published in JAMA Surgery.
“For advanced gastric cancer (AGC), laparoscopic gastrectomy is considered technically difficult owing to the large tumor size and lymph node metastasis. To clarify the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection for AGC, outcomes of several prospective studies have been reported recently,” Tsuyoshi Etoh, MD, of the department of gastroenterological and pediatric surgery at Oita University in Japan, and colleagues wrote. “Although these secondary analyses seem informative for clinical practice, a primary endpoint on a longer follow-up period is clearly more robust for verifying noninferiority of LADG for locally AGC.” Read more.
Burning Rock secures FDA breakthrough device designation for multicancer blood test
The FDA has granted breakthrough device designation to Burning Rock’s OverC multicancer blood test for early detection of esophageal, liver, lung, ovarian and pancreatic cancers, according to a company press release.
Intended for use in adults aged 50-75 years at average risk for cancer, the OverC liquid biopsy test may allow increased detection efficiency and enable early diagnosis and treatment compared with conventional cancer screening methods, according to the release. Read more.
1 in 6 early-onset colorectal cancer survivors diagnosed with subsequent cancer
CHICAGO — Among those who survived early-onset colorectal cancer, approximately 16% developed a second cancer, with higher risk reported among men, according to a population-based study presented at Digestive Disease Week.
“The number of cancer survivors is increasing and is projected to grow to 26 million by 2040 in the United States,” Aniruddha Rathod, PhD, MBBS, MPH, a postdoctoral researcher at Peter O’Donnell Jr. School of Public Health at University of Texas Southwestern Medical Center, told Healio. “These survivors are at an increased risk of developing another cancer in future.” Read more.
Cell-free DNA blood test ‘poised to have significant impact’ on CRC screening
CHICAGO — A cell-free DNA blood-based test displayed 83% sensitivity for colorectal cancer detection and 90% specificity in an average-risk population, similar to the performance of current noninvasive screening options.
“Colorectal cancer screening is recommended for everyone in the United States,” Daniel C. Chung, MD, director of the High-Risk GI Cancer Clinic at Massachusetts General Hospital and professor at Harvard Medical School, told attendees at Digestive Disease Week. “But, despite the widespread availability of many screening options, there remain persistent and significant barriers, and unfortunately, screening rates remain suboptimal. In fact, only 59% of eligible individuals aged 45 and over are adherent, which is well below the acceptance target rate of 80%.” Read more.
Genescopy encourages colonoscopy with noninvasive CRC screening test
Geneoscopy Inc. announced favorable results from its CRC-PREVENT trial, which assessed noninvasive, stool-based, at-home screening for colorectal cancer and advanced adenomas.
Geneoscopy’s stool test uses patented RNA biomarker technology to screen for CRC and advanced adenomas that might indicate a higher risk of developing cancer. Read more.
Excess weight increased risk for colorectal cancer, independent of genetic risk
Excess weight, regardless of polygenic risk score, correlated with an increased risk for colorectal cancer, according to results from a population-based, case-control study.
“Accumulated evidence has shown that a high BMI, as a proxy for excess body weight, is associated with increased CRC risk,” Xuechen Chen, MMed, of the division of clinical epidemiology and aging research at the German Cancer Research Center, and colleagues wrote in JAMA Network Open.
He added: “Polygenic risk scores (PRSs), the combination of multiple single nucleotide variations identified in genome-wide association studies, are increasingly used for CRC risk stratification and also are useful to improve limited statistical power in gene-environmental studies that often suffer from weak effects of single risk loci and harsh penalty of multiple comparison corrections.” Read more.