CANCER IS ONE OF THE LEADING HEALTH PROBLEMS WORLDWIDE, with an estimated 1,806,590 new cases diagnosed in the United States in 2020. According to the National Cancer Institute, this number is expected to increase to a staggering 29.5 million by 2040. The high incidence rate has paved the way for a sudden influx of at-home cancer-testing kits on the market.
The COVID-19 pandemic played a huge role in the sudden popularity of at-home cancer screening as well. With most people restricted to their homes and many healthcare facilities putting elective procedures on hold, it was only a matter of time before patients and healthcare professionals started looking for alternative options. Once people starting using at-home cancer-screening kits, they realized how much more convenient they are—not just for patients, but also for hospitals by decreasing patient load.
Beyond convenience, at-home cancer testing offers patients a much higher degree of privacy, requires no time off work for a hospital or office visit, and can be used by people who refuse physical examinations for religious or social reasons. In addition, at-home screening is significantly less expensive than invasive screening procedures that must be performed in a medical setting, such as colonoscopies.
How do these tests work? Athome cancer-screening tests utilize specifically designed algorithms to detect levels of certain chemicals in self-collected samples of saliva, urine, or feces. If positive, patients are required to seek additional care for confirmation.
In terms of accuracy, some at-home tests compare more favorably than others to screenings performed in clinical settings. For example, the sensitivity of at-home colon-cancer-screening tests is relatively high (92% for Cologuard, 72-74% for FIT). On the other hand, studies have found a decreased specificity in at-home screening test results for cervical cancers, meaning these kits produce more false positives.
Due to their relatively high degree of sensitivity, at-home screening tests for colon cancer are increasingly being recommended by physicians for low- to average-risk patients, especially those with medical contraindications for a colonoscopy. This saves time for patients and health professionals by limiting the number of people who have to go through a time-consuming and invasive procedure like colonoscopy, which remains the gold standard for colon cancer diagnosis. Furthermore, FIT and fecal occult blood testing (FOBT) are now recommended as a parallel option to colonoscopy every 5 or 10 years.
HPV (human papillomavirus) testing kits have increased the screening for previously under-targeted groups, for example rural populations, immigrants, and same-sex couples or those refusing gynecological examination. Increased screening via self-collection, leading to earlier diagnosis, has contributed to a better prognosis for various cancers, as well.
From a financial perspective, while genetic testing (e.g., for breast cancers) may not be covered by various insurance plans, there is a higher likelihood of such testing being covered once patients meet the high-risk criteria, as determined by at-home testing.
While convenient, these kits do have their drawbacks. A positive test result delivered directly to the patient with no guidance from a doctor can create undue anxiety and confusion, often leading to inaccurate self-diagnosis. Because patients lack the clinical knowledge of cancer prognosis and basic clinical handling of test results, they often end up misinterpreting them. This is why the test-kit manufacturers recommend sending results to identified labs for proper interpretation of results. If the instructions given on the box are correctly followed, this risk can easily be reduced.
Also on the potential downside, an insignificant test result can lead to false reassurance, some patients may have difficulty handling the biological (fecal/urine) sample, and some might find the testing kit instructions difficult to follow.
While doing something is always better than doing nothing when it comes to cancer screening, one form of cancer is not a good candidate for at-home testing—prostate cancer. The kits used to screen for this cancer check for a protein called prostate-specific antigen, or PSA, which can be elevated in men with prostate cancer. However, elevated PSA can also be found in people without prostate cancer. Also, many factors can affect the level of PSA, such as age, exercise, certain drugs, and prostate infection. So, it’s best to be tested for prostate cancer in a hospital under a doctor’s supervision.
In conclusion, it is safe to say that despite some drawbacks, which include lower sensitivity and specificity, home cancer testing has significantly increased screening and earlier diagnosis of cancer. This has led many to believe that the positive aspects outweigh the disparities in accuracy. When done according to manufacturers’ instructions and the results are interpreted by designated health professionals, at-home test kits have the potential to improve prognosis and survival.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy, specialized pharmacy, and IV services. The cancer center consists of 9 medical and 2 radiation oncologists along with 10 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.
The most widely available at-home cancer-screening kits include those for colorectal cancer (the fourth most common cancer), the most popular being the fecal immunochemical test (FIT) and Cologuard ® , as well as for breast cancer, cervical cancer, ovarian cancer, and several others.
