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Howard G. Smith, M.D. is a former radio medical editor and talk show host in the Boston Metro area. His "Medical Minute" of health and wellness news and commentary was a regular weekday feature on WBZ-AM, WRKO-AM, and WMRE-AM. His popular two-way talk show, Dr. Howard Smith OnCall, was regularly heard Sunday morning and middays on WBZ.

Dr. Smith has adopted audio and video podcasting as conduits for HEALTH NEWS YOU SHOULD USE. Based on the latest medical, health, and wellness literature these reports provide practical information you can use to keep yourself and your family healthy. Many reports have video versions, and Dr. Smith’s YouTube Channel may be found at: http://bit.ly/2rNw6XQ

Trained at Harvard Medical School and a long-time faculty member at Boston Children’s Hospital, he practiced Pediatric Otolaryngology for 40 years in Boston, Southern California, and in central Connecticut.  He is now based in New York City.

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  2. Stool Testing Can Replace Colonoscopy

Stool Testing Can Replace Colonoscopy

Mar 1, 2019

Vidcast: https://youtu.be/nzwEnrwCHOo

We all must screen for colon cancer.   New data suggests that  you might be able to use a simple chemical test at home to replace that nasty bowel prep followed by either colonoscopy under anesthesia or a CT scan.  

A meta-analysis by Indiana University of some 31 studies testing more than 120,000 persons shows that the so called FIT test, the fecal immunochemical test, is so sensitive and specific that it may be used on an annual basis by many of us in place of the screening colonoscopy.

The FIT test may be purchased over the counter online for $10 to $30 and looks specifically for a chemical trace of blood in the stool. You need not follow any special diet or avoid any medications before using the test.  

Each FIT test is different.  With some, you simply place a bit of stool on the test surface and cover the zone before dropping on developing liquid or mailing it off to the lab.  With others, you toss an indicator strip into the toilet bowl with the stool and watch for a color change.

This test is only appropriate for healthy persons without a history of polyps and without a family history of bowel disease including polyps and cancer.  It can only detect blood in the stool and will not reliably detect polyps.  It must be repeated yearly, and, if the test is positive, you must have a colonoscopy.

The FIT test is different from the stool DNA Cologard test, the only FDA approved genetic test for colon cancer.  The Cologard is prescription-only, costs more than $600 though insurance may cover part of the cost, and looks for cancer DNA.  It is likely no more sensitive for screening purposes than the FIT test, and it carriers a significantly higher price.

You should discuss colon screening with your own doctor before deciding which route to use.  Just know, though, that colonoscopies with scopes or a CT scan are not your only options.

#colonscreening #colonoscopy #FIT #fecalimmunochemicaltest #healthnews

Thomas F. Imperiale, Rachel N. Gruber,Timothy E. Stump, Thomas W. Emmett, Patrick O. Monahan. Test Characteristics of Fecal Immunochemical Tests for Colorectal Cancer and Advanced Adenomatous Polyps: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 2019 DOI: 10.7326/M18-2390