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Exact Sciences Corporation Message Board

earwaxisafuel 4 posts  |  Last Activity: Nov 20, 2015 5:01 PM Member since: May 9, 2006
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  • Reply to

    No USPSTF decision until end of 2016

    by ranjovance Nov 19, 2015 9:36 AM
    earwaxisafuel earwaxisafuel Nov 20, 2015 5:01 PM Flag

    Well those numbers are somewhat flexible. There is no doubt that FIT was developed in the 1980s and that it did not become wide-spread until the 2010s in the US. Read the review by Allison (Mr. FIT) in 2014 - don't take my word for it (Gut Liver. 2014 Mar; 8(2): 117–130).
    That being said, FIT is about as big an improvement over gFOBT for detection of cancers and adenomas as CG is over FIT. Obviously, for SSAs CG is way better and FIT is worthless. There is also a much larger financial incentive for marketing of CG than there was for FIT and there is no competition. Therefore, all those factors suggest the comparison is not perfect. My main point is that it takes a lot of education (and time) to change medical practice in the trenches.

  • Reply to

    No USPSTF decision until end of 2016

    by ranjovance Nov 19, 2015 9:36 AM
    earwaxisafuel earwaxisafuel Nov 20, 2015 4:08 PM Flag

    My Employer? Umm, no.

  • Reply to

    No USPSTF decision until end of 2016

    by ranjovance Nov 19, 2015 9:36 AM
    earwaxisafuel earwaxisafuel Nov 20, 2015 4:07 PM Flag

    I'd agree with you SSteph, with the caveat that since both tests (FOBT, FIT) are measuring blood in the stool, I think in many minds they were the same. Further, there was a distinction between qualitative and quantitative FIT with the latter being more preferred but the distinction wasn't really highlighted until later (read a review by Allison in 2014 if you are interested). I spoke with the head of reimbursements for a medium sized HMO a couple of years ago, and she didn't even know the difference between the two, even though off the top of her head she knew what approximate fraction of their PCPs used fecal blood testing. Because CG is significantly better, and a completely different method, I think it will see faster traction than the FOBT - FIT transition. That being said, imo it won't be as quick as some here may have hoped.

  • Reply to

    No USPSTF decision until end of 2016

    by ranjovance Nov 19, 2015 9:36 AM
    earwaxisafuel earwaxisafuel Nov 20, 2015 12:28 PM Flag

    I am posting this in the anticipation that it will be removed, as pretty much all my posts have been for a while, but here goes. While I don't think KC anticipates that they will change the recommended guidelines, he seemed to suggest that Exact, and a number of other parties, are trying to get the USPSTF to clarify the recommendations. I think this would be a small step forward, rather than remaining in this "alternative" universe. I don't know about others on this board, but I didn't expect a home run overnight or even in the first two years. I think we will start seeing a really strong ramp up starting in 2017-18. Probably the best way to look at conversion from FIT to CG would be to look at the time for conversion from FOBT to FIT. Even though FIT was available in the 1980's with large scale comparisons available in the mid - 1990's it wasn't until the 2010s that it really started to supplant FOBT (except in Japan where conversion to FIT happened much earlier). Most organizations still lump (and recommend) FOBT and FIT together (likely due to the fact that they both involve blood).

    With CG we are talking about changing medical practice - this doesn't happen overnight. Tha fact, however, that so many CG test takers are getting screened their first time is encouraging. Further, I recently saw WebMD's comparison between FOBT/FIT/sDNA and here is a quote :
    "Of the three tests, this one [CF] has the easiest instructions." They then go on to talk about other conditions besides CRC that can lead to blood in stool.

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