How good is optical colonoscopy for colon cancer screening? Only 70% effective? 8

How good is optical colonoscopy for colon cancer screening? Only 70% effective? 8

How good is optical colonoscopy for colon cancer screening? Only 70% effective? 8

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Colonoscopy is said to be a “gold standard” for colon cancer detection. But there is data that optical colonoscopy detects only 60-70% of right-sided colon cancers. Maybe it’s time to focus on CT colonography? Dr. Anton Titov, MD. Or “swallow and forget” camera technologies? Dr. Anton Titov, MD.


Optical colonoscopy is considered golden standard in colorectal cancer screening. But it's very interesting that sometimes a certain number of right-sided colon cancers are missed. People say this. A 90% colorectal cancer reduction with doing optical colonoscopy. In reality it is actually closer to 60 to 70% colon cancer reduction in some published clinical trials. What is the best way to screen for colorectal cancer today? Dr. Anton Titov, MD. What are the new methods of colorectal cancer screening? Dr. Anton Titov, MD. What are you working on? Dr. Anton Titov, MD. What colon cancer screening methods are coming to clinical practice? Dr. Anton Titov, MD. Dr. Anton Titov, MD. I think in 2020 and 2021 still optical colonoscopy is the way to go. What we have to do is to try to better pinpoint and choose the patients that have a significantly increased risk of colorectal cancer. For that we are trying to develop new cancer screening tests. It's amazing that about 80% of these new cancer screening technologies are coming from Israel. I am very proud of it. I'm basically also involved in a few of new colorectal cancer detection methods. Dr. Nadir Arber, MD. We are doing one clinical trial, which is amazing and very promising with colorectal cancer checkup. It's another Israeli startup. This is a technology that I call "swallow and forget". It's a prep-less cancer screening by capsule endoscopy. You just swallow it. There is no need for bowel cleansing preparations, no need to do anything. It's just has a small source of energy which is transmitted into the mucosa. It does back scattering and the absorptions. Capsule can tell if there is normal bowel mucosa or there is some polyp or colon cancer. Dr. Anton Titov, MD. We have published two papers and now we are doing in Israel a multi-center clinical trial to find out efficacy of colorectal cancer screening. It will be followed by international clinical trial. This is colon cancer screening technology that is going to be amazing. Still the cost might be the issue. Another thing that I alluded to in the beginning of our interview is a blood test for early colon cancer detection. In my lab and two labs in America and other centers across the world we work intensely on early cancer screening tests. Two of laboratories are from Johns Hopkins and one laboratory is from Australia. But definitely blood cancer screening tests have be validated in international multicenter clinical trials. But again this is a way to go. You have to have a colon cancer test. But if it's possible to have a test to detect all cancers, it's even better. And then only patients in whom we know that there is very high likelihood of finding cancer, or colon cancer. Obtain medical second opinion on cancer. Then only those patients will be sent to have colonoscopy. In this way we can use the resources better and also the compliance from the patients will be better. Because currently we are doing a lot of colonoscopies which are normal. Sometimes you can find a way not to do colonoscopy. Because cancer risk in not high. Obtain medical second opinion on cancer. Then we can achieve much better results and even increase our ability to prevent colon cancer early in the preclinical stage.

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