Obesity in men could dictate future colon screenings
(Photo: Kaiser Permanente) The FIT screening is more accurate and convenient than earlier stool tests Test can be performed in five minutes, without any prep the night before But the home-based screening doesn’t detect polyps as well as colonoscopies SHARE 76 CONNECT 88 TWEET 3 COMMENTEMAILMORE An inexpensive, home-based test could be a good way to get more Americans screened for colorectal cancer, the country’s second-leading cause of cancer death, a new study suggests. Screening patients with a single FIT or fecal immunochemical test detected 79% of colorectal cancers, according to a report in today’s Annals of Internal Medicine. That compares well to colonoscopies, which find more than 95% of colorectal cancers, says lead author Jeffrey Lee, a post-doctoral researcher at the Kaiser Permanente Division of Research in Oakland and the University of California, San Francisco. Although doctors have debated the best method of screening for colorectal cancer, most agree on the importance of getting more people tested, no matter what method. About 30% of eligible adults have never been screened at all, Lee says. But squeamishness can put people at higher risk of dying from an often preventable disease, says Richard Wender, chief cancer control officer at the American Cancer Society, who was not involved in the new study. More than 142,000 Americans are diagnosed with colorectal cancer each year, and more than 50,000 die, according to the cancer society. The American Cancer Society recommends people at average risk begin screening at age 50, either with a colonoscopy every 10 years; flexible sigmoidoscopy every five years; double-contrast barium enema every five years; CT colonography, or “virtual colonoscopy,” every 5 years; or with a fecal test every year. In the past, fecal tests were seen as some of the least effective options. They work by detecting blood in stool. Patients use brushes included in test kits to take samples, then mail them back to a doctor or lab. An older version, the fecal occult blood test, or FOBT, detected only 13% to 50% of colorectal cancers, Lee says. But the new analysis, which examined the results of 19 earlier studies, shows that the newer FIT screening produces “excellent” results, Wender says. Other improvements could make the FIT a more attractive option, Lee says. Unlike the FOBT, which required people to take three samples typically over three days the FIT uses just one sample.
Jenifer Fenton, assistant professor and researcher in the Department of Food Science and Human Nutrition, and Kari Hortos, associate dean in MSU’s College of Osteopathic Medicine at the Macomb University Center, led the 18-month, cross-sectional study, which followed 126 healthy, white American males ranging from 48 to 65 years of age. Participants showed no signs or symptoms of health issues, yet underwent routine colonoscopies. “What we found is 78 percent of the 126 men in the study were either overweight or obese based on their BMI or waist circumference. Of those, about 30 percent were found to have more than one polyp after colonoscopies were performed,” said Fenton. “In fact, the more obese participants were 6.5 times more likely to have three polyps compared to their thinner counterparts.” Sarah Comstock, a co-author of the study and research fellow in the Department of Food Science and Human Nutrition, also indicated that the significance of the research is twofold. “Not only does it show the association that leptin and a higher BMI have with colon polyps, but it gives us a better snapshot on how body weight and other factors may actually help us determine who might be at a higher risk of developing polyps,” she said. With obesity rates climbing during the past 20 years within the United States and colon cancer being the second-leading killer of men and women in the nation, these facts compelled Fenton and her team to conduct research which could identify the specific biomarkers of obesity and early-stage colon cancer and help in prevention efforts. Previous research published by Fenton in 2009 identified the connection between obesity and colon cancer through examining tissue hormones. These studies demonstrated that, at higher levels, leptin worked as a primary mechanism in inducing precancerous colon cells by increasing the blood supply to them and promoting their progression. “Even with all of our research, there’s still more to be done, particularly in larger, more diverse populations, before any changes in screening recommendations can be made,” said Fenton. “But we’ve definitely got a good start.” Story Source: The above story is based on materials provided by Michigan State University . Note: Materials may be edited for content and length. Journal Reference: Sarah S. Comstock, Kari Hortos, Bruce Kovan, Sarah McCaskey, Dorothy R.
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