Dr. Aasma Shaukat breaks down the latest breakthroughs in colon cancer screening and detection—from risk scores and game-changing blood-based tests to the powerful role of artificial intelligence in detecting cancer earlier and more accurately. Dr. Shaukat also discusses her research into making screening more accessible in underserved communities.
Dr. Aasma Shaukat is Professor of Medicine and Gastroenterology and Director of Outcomes Research in the Division of Gastroenterology and Hepatology at NYU Grossman School of Medicine. Learn more about Dr. Shaukat.
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Transcript
Jamie Forward:
What are the latest advances in colon cancer screening and detection?
Dr. Aasma Shaukat:
There’s a lot of movement in this space. We’re always trying to improve our ways to detect colon cancer early. And particularly, when it’s at the pre-cancerous stage, these polyps or growths that we worry about. We’re also trying to understand if we can create risk scores to better understand when somebody is at risk.
Because right now, we just use age as a cutoff; age 45 and older for individuals that don’t have symptoms or a family history. But we understand that that’s imperfect, and some individuals probably need to come to the screening fold earlier. And the good news is some individuals can probably wait.
So, putting all those factors together, that could tell us somebody’s risk at any given time point, so we can advise them on screening or no screening. The other important advancement is development of blood-based tests for colon cancer screening. Up until now, our options were either a screening colonoscopy or a stool-based test.
But now there’s one FDA-approved test for a blood-based test option. And there’s probably one more that’s close to approval. And in the next few years, we expect several more. So, this field is only going to grow in terms of options that patients have.
Jamie Forward:
Wow, that’s really exciting. Who can access this blood-based test?
Dr. Aasma Shaukat:
At the moment, this test is approved for Medicare patients. So, individuals that have Medicare coverage. Other commercial and other payers have made kind of a case-by-case basis. So, with any other insurance carriers, check with your insurance carrier if they do cover the test or not.
Jamie Forward:
That’s good to know. So, what about artificial intelligence? Is that impacting advances in research for colon cancer screening?
Dr. Aasma Shaukat:
Absolutely. I think AI is in every aspect of our life. So, in terms of colon cancer screening, it has two applications currently. One is development of these risk scores that I mentioned.
So, essentially, looking through the chart or a person’s journey up until this point. To put together either information or sequences that we as humans can’t really detect to tell us who is at risk for colon cancer, that we should bring into our screening fold. The second application is some of these newer blood-based tests are using AI to improve their algorithm. So, they draw blood and try to detect a signal in the blood for any small amounts of DNA that’s shed from a growing tumor or cancer.
But then we used AI and machine learning to improve that algorithm. So, we think it’ll help make the tests more accurate. And the third application, which we use a lot of, is in colonoscopy. We now have computer-aided detection.
So, it’s an AI software that actually looks along with us. The idea is, it gives us a second set of eyes, so that when we’re doing colonoscopy and if we happen to see a polyp, the AI system actually also looks with us. And points our attention to things that, perhaps, could be polyps that we could easily overlook—ensuring that we have a high-quality colonoscopy and we don’t miss any lesions.
Jamie Forward:
Can you tell us about the areas of colon cancer research that you’re currently involved in?
Dr. Aasma Shaukat:
Yes, absolutely. So, in terms of clinical research, at the moment, we are conducting a clinical trial to understand the best way to improve colon cancer screening rates amongst individuals that may have low screening rates. And our study is currently focused on in multiple community clinics across New York City, where there’s a lot of individuals that are non-English speaking or underserved. And we’re trying to understand and boost adherence rates to colon cancer screening.
We’re also doing studies on developing new biomarkers, including blood and stool tests so that we can understand how to improve existing colon cancer screening studies. With the idea, perhaps, that we can have a more sensitive and a more accurate, noninvasive test in the near future.