Colon Cancer Rising In Adults. ColoSense Offers Noninvasive Screening Tool.

James Van Der Beek, of Dawson’s Creek, revealed he was diagnosed with stage 3 colon cancer at 47, after already experiencing symptoms. As a physician, I see too often that warning symptoms for colon cancer—like rectal bleeding, changes in stool, weight loss, or abdominal pain—go unrecognized as concerning. Worse, many people do not know the recommended screening age was lowered from 50 to 45 in 2021, an update that added 19 million people to the eligible screening pool. Van Der Beek’s openness serves as a generous reminder of the importance of recognizing symptoms and getting screened early.

And while colonoscopy remains the gold standard for prevention, it’s not always accessible. That’s why new noninvasive screening tools, like the recently FDA-approved ColoSense, are being developed to expand access. Here’s why non-invasive screening for colon cancer is on the rise.

Colon Cancer is a Growing Health Care Crisis

Colon cancer, also called colorectal cancer, is found in the colon and rectum of the large intestine. Data shows colon cancer rates have been increasing in adults under age 50 by 1-2% per year since the 1990s. In my clinical practice alone, I now frequently encounter individuals in their 20s and 30s with advanced stage colon cancer. The lowest common denominator for many of these cases is lack of awareness. They were unaware of colon cancer symptoms, their risk factors, or the recommended screening age for routine colonoscopy. Or, when symptoms were raised by patients, they were ignored by a physician who was unaware of this growing trend.

Education, for patients and physicians, is critical to slowing the rise in colon cancer rates. Yet awareness alone is not enough—patients also need access. And right now, access is constrained.

The Capacity Challenge with Colonoscopies

Co-founder and Chief Medical and Science Officer of Geneoscopy, Dr. Erica Barnell, explains, “With the new, lowered age threshold for screening, millions more patients now qualify, but there aren’t enough gastroenterologists or colonoscopy slots to meet the increased demand.”

Currently, an estimated 44 million people in the United States are eligible for colon cancer screening. Yet the physician workforce is limited: only about 17,000 gastroenterologists treat adult patients, and over half those physicians are age 55 or older. Compounding the problem, colon cancer is increasingly diagnosed before age 45. Some policymakers have even proposed lowering the recommended screening age to 35—a well-intended change that could further strain an already overwhelmed system.

To improve access to screening and decrease the workload of colonoscopies, Geneoscopy developed ColoSense, a noninvasive screening option that detects colon cancer and precancerous lesions through a stool sample. ColoSense was approved by the FDA in May 2024, and is among the newest noninvasive screening options for average risk patients. Unlike methylation-based stool DNA tests, ColoSense uses RNA biomarkers to detect cancer and precancerous signals.

In a large pivotal trial, the RNA-based stool test detected 93% of colorectal cancers and 45% of advanced adenomas (precancerous lesions), while correctly identifying people without lesions 88% of the time. Compared with the fecal immunochemical test (FIT), it showed notably higher sensitivity for both cancers (93% vs. 78%) and precancerous growths (45% vs. 29%). Barnell adds that, “ColoSense showed strong sensitivity across all age groups.”

How ColoSense Streamlines Colon Cancer Screening

ColoSense is designed for patient comfort and convenience. Unlike other stool tests that require scraping or special handling of your stool, Colosense simplifies sample collection. Once stool is collected, the kit can be easily returned via FedEx to a designated laboratory and the results of the test will be shared with you and your clinician.

Importantly, Colosense is positioned to complement, not replace, a colonoscopy. Patients who test positive still need colonoscopy for confirmation and polyp removal. But by identifying those who most needs an invasive test, like the colonoscopy, noninvasive tests can “de-burden” the system, ensuring colonoscopy capacity is reserved for those at highest risk.

Coverage, Cost, and Care Navigation for ColoSense

Even with FDA approval, barriers remain for noninvasive tests and insurance coverage is patchy. Fortunately, ColoSense is seeing more coverage with private insurance, state Medicaid plans, and it is currently under review for Medicare coverage. The ColoSense test is priced at $508.87, a rate established by the Centers for Medicare & Medicaid Services (CMS). While patients can pay cash upfront, Barnell emphasizes, “Our goal is no patient paying out-of-pocket if their provider orders the test.”

“Another strategy to minimize inequity is by providing end-to-end concierge care,” Barnell adds. ColoSense helps patients connect with local physicians if results are positive, ensuring timely colonoscopy for visualization and possible polyp removal. She feels this approach aims to reduce not just financial burdens but the cognitive and logistical hurdles that prevent many from completing screening.

Colonoscopy Still Remains the Gold Standard

While the convenience, cost, and accessibility of ColoSense improve screening and early detection, colonoscopy remains the gold standard. Many patients fear the preparation—temporary dietary restrictions and a bowel cleanse—which is widely regarded as the most challenging part. The procedure itself is done under sedation, typically takes about 30 minutes, and allows for same-day recovery.

Serious risks, such as perforation or bleeding, are very rare, and the benefit—removing polyps before they can turn cancerous—is life-saving. To prevent complications, patients are carefully assessed for the safety of preparation, sedation, and the procedure itself.

Colonoscopy is preferred for high-risk patients: those with a family history of colorectal cancer, genetic syndromes, suspicious findings on prior imaging, or abnormal stool or blood tests. For average-risk patients who are unable to undergo colonoscopy, however, ColoSense provides an FDA-approved, noninvasive alternative.

Continued Need for Patient Education and Advocacy

Patient and physician education is of critical important.

James Van Der Beek’s experience illustrates what can happen when subtle symptoms intersect with limited awareness of colon cancer. By sharing his journey, he helps educate others which can save lives. The medical community—and our patients—are grateful for his advocacy.