Colorectal Cancer: Meeting the Challenge

Article preview reprinted from Medtech Insight - August/September 2009

Medtech Insight -- Early detection of colorectal cancer can dramatically improve an individual's chances for avoiding this deadly disease, and screening colonoscopy is the gold standard for CRC prevention. One detractor, however, is patient avoidance due to perceived discomfort of the bowel preparation process and the colonoscopy itself. Mitigation of these concerns has prompted companies to look for less invasive or even noninvasive screening solutions that have the same sensitivity as diagnostic colonoscopy. These emerging technologies range from advanced endoscopic devices to new methods of in vivo tissue characterization. Read more...

Colorectal Cancer: Meeting the Challenge

Article preview reprinted from Medtech Insight - August/September 2009

Excluding skin cancer, colorectal cancer (CRC) is the third most commonly diagnosed cancer in the US and the third leading cause of cancer-related death. According to the American Cancer Society, an estimated 106,000 new US cases of colon cancer and 50,000 new cases of rectal cancer will be diagnosed this year, and nearly 50,000 people will die of CRC. All told, 1 in 19 people in the US can expect to develop CRC in their lifetime. Early detection of CRC can dramatically improve an individual's chances for avoiding this deadly disease, and screening colonoscopy is the "gold standard" for CRC prevention.

According to industry estimates, there are approximately 26 million colonoscopies performed each year, and this number is on the rise. Patient screening compliance has grown by 20% in the US since 2003, a trend driven predominantly by greater understanding about colon cancer among the general population and more awareness of the importance of early detection. Over the next decade, we can expect to see a further increase in public awareness due to the efforts of physician societies and national activist groups, such as the Colorectal Cancer Coalition and the Colon Cancer Alliance, as well as awareness and advocacy activities taking place on the state level.

One detractor, however, is patient avoidance due to perceived discomfort of the bowel preparation process and the colonoscopy itself. Additionally, patients are embarrassed by the postprocedure release of air used to insufflate the colon during a colonoscopy. Mitigation of these concerns has prompted companies to look for less invasive or even noninvasive screening solutions that have the same sensitivity as diagnostic colonoscopy. Technologies under development include virtual or computed tomography (CT) colonography, capsule endoscopy, and fecal testing for genetic markers.

New ways to deliver high quality screening and diagnostic procedures for colon cancer were a major theme within the gastroenterology community at this year's Digestive Disease Week (DDW) conference, held in Chicago this spring, where attendees discussed the relative merits of a number of emerging technologies, ranging from advanced endoscopic devices to new methods of in vivo tissue characterization.

Screening Drives Procedure Base

CRC develops over a period of years and manifests itself as abnormal growths or lesions in the mucosal tissue lining the colon and rectum. Because of the slow progression from dysplasia through adenoma and on to cancer, regular screening and surveillance are effective in preventing the onset of CRC. A screening test either looks at the structure of the colon (ie, imaging tests) or at chemical markers found in the stool (ie, histology tests), and the various tests have unique pros and cons.

- Robert Dunki-Jacobs is an independent medical device consultant and a contributing writer for Medtech Insight.

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Companies mentioned in this article:

Avantis Medical Systems Inc.

Dartmouth College

Duke University

Fuji Photo Optical Co. Inc.

Fujinon Inc.

Given Imaging Ltd.

Indiana University

Johnson & Johnson

Ethicon Endo-Surgery Inc.

Massachusetts General Hospital

Mauna Kea Technologies SAS

MediSpectra Inc.

Mount Sinai Medical Center (NY)

Mount Sinai School of Medicine

National Institutes of Health

Olympus Corp.

Olympus America

Oregon Health & Science University

Pentax Corp.

Pentax Medical Co.

SpectraScience Inc.

Spirus Medical Inc.

US Department of Health and Human Services

University of Chicago

University of Chicago Medical Center

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