Looks my message cut off again!! Point is- a test can be "too" sensitive if it is picking up irrelevant lesions causing unnecessary further testing (99% of polyps
Correct, but as the cancer increases in size the sensitivity improves- 66% if 2cm or greater.
Since 99% of polyps
Interstingtom I'm not sure you understand what sensitivity and specificity mean, A sensitivity of 44% for pre cancers mean that out of 100 pre cancers, 44 were found and 56 were missed. If the specificity was 87% then 13% of the +' tests would be false +.
The sensitivity for cancers was 91% with a specificity of 87% which means 13% of the +'s were false positives. Hope that helps.
Sailing - what are you thinking here and do you think Exact has "control" over the publication date?
Wow- NEJM The big time. No smoke and mirrors Chines vaccine company
Agree- likely NEJM with the associated media noise. Important original articles like this often are accompanied by an editorial. I think the key to where we go in the short term will be the interpretation and tone of the editorial.
Sorry if this has been posted before.
The incidence of colorectal cancer is rising sharply among younger adults in the United States, a study showed.
Researchers analyzed Surveillance, Epidemiology, and End Results (SEER) data for 383,241 patients in whom colorectal cancer was diagnosed between 1975 and 2010.
In stratified analyses, the annual percentage change fell significantly among patients aged 50-74 at diagnosis (–0.97), and aged 75 years and older at diagnosis (–1.15). But it rose among patients aged 35-49 at diagnosis (0.41) and especially among patients aged 20-34 at diagnosis (1.99).
A predictive model suggested that if the observed trends persist between 2010 and 2030, the incidences of colon cancer and of rectal/rectosigmoid cancer will rise by 90% and 124%, respectively, among 20- to 34-year-olds, and by 28% and 46%, respectively, among 35- to 49-year-olds.
"We saw dramatic rises in the predicted incidences of both colon and rectal cancer in our younger cohort that point out that further studies need to be done to determine why this is happening and what can we do now to prevent this trajectory from occurring in the future,"
Exact may have a larger screening population sometime in the future.
KD - "What would be most cost effective, would be to use Cologuard in place of colonoscopies for all colon cancer screening and refer positive patients for colonoscopy."
This may be true, but KC has clearly stated that this is NOT the way EXAS will market the test. EXAS will market the test as THE best alternative to anyone who should be screened but will not (for whatever reason) get a colonoscopy. His goal is to replace the Millions of FOBT's and FITS presently being done.
As far as other potential uses that Colosurgeon suggests, the medical community might use it in those ways but that will done "off label" as it will be approved as a "screening test" and not a diagnostic tool in a patient with symptoms as Colosurgeon suggests.
BTW, as a doc I would never get a Cologuard in a patient under 50 with GI bleeding and be satisfied with a negative result - that is a big lawsuit waiting to happen. Makes me wonder if Colosurgeon is really a Doc?
Agree NEJM. At last call KC said Maybe December but more likely early 1st quarter. I was hoping that meant January but obviously not. Maybe you're right about Colon cancer awareness month. Most things seem to be running a bit behind schedule.
It's about an inch long. From a medical summary:
This technique, while less invasive than optical colonoscopy, requires a more rigorous bowel preparation regimen. Colonic capsule endoscopy does not allow for biopsy or polyp removal, so patients with lesions detected during the examination typically require subsequent colonoscopy for further evaluation and/or treatment.
Several studies of colon capsule endoscopy have found a relatively low sensitivity for polyp detection with this technique, when compared with colonoscopy. A meta-analysis found that the sensitivity for significant polyps ( 6 mm or three or more polyps) was 69 percent with a specificity of 89 percent . In a subsequent study in 545 patients undergoing screening, two of the five cancers detected by colonoscopy were not identified by capsule endoscopy, and the sensitivity of capsule endoscopy for significant polyps was only 39 percent . These findings suggest that the current technique is not sufficiently accurate for screening.
It's recommended for patients who can't undergo a regular colonoscopy.
GTPH -What would you say is more invasive? Pooping in a container in the privacy of your own bathroom or being a woman and having a person you never met place a speculum in your #$%$ using a LuViva scope to identify dysplasia and then having to freeze or electrically excise a good portion of your cervix. Would any of the women on the board like to weigh in on that one.
I'm not saying that LuViva might not have merit in evaluating cervical dysplasia/cancer but don't act like it's less invasive than Cologuard - because it's not.
Diceman -you gave me a good laugh with .
" NO room, NO 2 phds, NO 2 assts, and NOT a drop of propranolol"
No wonder you had such a bad experience - getting propranolol ( a blood pressure med) instead of propofol (an anesthetic agent) for your colonoscopy!
Bilive® junior is suitable for use in non-immune infants, children and adolescents from one year up to and including 15 years old who are at risk of Hepatitis A and Hepatitis B infection.
Bilive® adult is suitable for use in non-immune adults and adolescents 16 years of age and older, who are at risk of Hepatitis A and Hepatitis B infection.
According to KC in the last call "With respect to the publication, there is still some chance that there could be a publication in December. However, we think that it's more likely to be in the early part of Q1."
That's the latest I've heard.