June 2017 | STOCKHEAD
Special Report: The message about the need to check for bowel cancer isn’t getting through, with screening rates still lower than half of all people who should be taking the test. That suggests it’s time for a new approach to screening. Last week the American Cancer Society lowered the recommended age for bowel cancer screening from 50 to 45 after finding incidences of bowel cancer were increasing among younger adults in the at-risk age group.
The US authority recommended either annual fecal immunochemical tests or visual examinations at longer intervals — colonoscopy every 10 years or sigmoidoscopy every five years. Other options include a higher sensitivity stool test, a DNA test, a physical examination or a CT colonography. That news sent shares in US-listed Exact Sciences — a company that sells the Cologuard stool test — up sharply.
Getting people to take the test
In Australia take-at-home kits are sent out to people between 50 and 74 years once every two years. Were local guidelines to change, companies such as Rhythm Biosciences (ASX:RHY) could be on the receiving end of a similar share price bounce. Australia’s participation rates for bowel cancer screening are low. Only 40 per cent of all over-50s who receive the take-at-home tests undertake the procedure — even though the disease has a 90 per cent cure rate if it’s found early.
The CEO of Bowel Cancer Australia, Julien Wiggins, says it’s still the squeamish factor that’s preventing people from taking it. The take-home test is a fecal test which requires people to “scrape the tip of the stick over different areas of the surface of the poo” and send the sample off to the National Bowel Cancer Screening Program, according to the Ministry of Health.
“When it comes to the at-home test it comes down to a number of factors,” Mr Wiggins told Stockhead. “The test still involves sampling of your poo, there’s no easy way to say it. “It’s a conversation killer. We’re inherently up against that.” He says 80 per cent of people still cite the process as messy and embarrassing.
Cancer Institute of NSW research in April found that 40 per cent of people who received the test didn’t take it because they didn’t have time. Another 15 per cent said they forgot, and 3 per cent said embarrassment stopped them from taking it.
New year, new test?
It also could be time for a new test to provide another option to people who are squeamish or unable to take the current version. About 16,000 Australians are diagnosed with bowel cancer per year, but because of the low screening rates 60 per cent of those will discover it after it has already spread. Mr Wiggins says blood tests in the past have worked to detect Stage 2 bowel cancer, which has a 70 per cent success rate when treated, but the problem there is that it’s already spread. “We would certainly have a preference for people to have a second option if they can’t do the [stool test].”
There are two alternatives to the fecal immunochemical test: Colvera, a DNA blood test which detects tumour DNA in the blood, and ColoStat, an in-development blood test that tests for protein biomarkers in the blood. Both are Australian. Colvera is owned by privately-held Clinical Genomics but is only used to test for recurrent colon cancer right now, according to the company. ColoStat is a technology developed in CSIRO and commercialised by Rhythm Biosciences. Unlike Colvera, Rhythm’s ColoSTAT is intended as a front-line diagnostic tool for screening people before they know they have cancer.
Rhythm is working with CSIRO scientists to develop new reagents for the “ColoSTAT” test, which uses antibodies to measure the levels of several proteins in the blood. The concentrations of these target proteins have been shown to vary in the presence or absence of colorectal cancer. Importantly, published results indicate that ColoSTAT is able to detect Stage 1 cancer. When detected at Stage1 the likelihood of treatment success is much higher than when detected at later stages. Giving people a second option may be exactly what the government needs to get its participation rate up to its target of 56 per cent.
This article was first written and published by Stockhead on June 2017, click here to visit their website.