Who Should Test?
Medical Guidelines and References
How to Order Testing For Your Patient

Who Should Test?

• Age 50 years and older at average risk for CRC
• Patients not compliant with colonoscopy or who want interim screening between colonoscopies
• Patients who do not have signs and symptoms of CRC
• High-risk patients who are noncompliant with standard screening recommendations or as interim screening between colonoscopies
• DNA stool testing is contraindicated for patients with IBD

Medical Guidelines and References

American Cancer Society guidelines for the early detection of cancer. 2002. CA Cancer J Clin. Jan-Feb;52(1):8-22.

http://caonline.amcancersoc.org/cgi/content/full/52/1/8

American College of Gastroenterology. 2003. Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence. Gastroenterology. Feb;124(2):544-60.

Zoorob R, et al. 2001. Cancer Screening Guidelines. Am Fam Phys 63(6):1101-1112.

NOTE: Stool-based DNA screening tests, such as PreGen-PlusTM, are relatively new technologies currently under review and not yet incorporated into medical guidelines.

http://www.ahrq.gov/clinic/3rduspstf/colorectal/colorr.htm

http://www.cdc.gov/colorectalcancer/for_healthcare/
screening_guidelines.htm

Key References:

Ahlquist, D.A. 2002. Stool-based DNA tests for colorectal cancer: Clinical potential and early results. Reviews in Gastroenterological Disorders. 2(1): S20-S26.

American Cancer Society. Colorectal Cancer Facts & Figures Special Edition 2005. Atlanta: American Cancer Society, 2005.

http://www.cancer.org/docroot/STT/content/STT_1x_
Colorectal_Cancer_Facts_and_Figures_-_Special_Edition_2005.asp

Boland, C.R. 2002. Molecular basis for stool-based DNA tests for colorectal cancer: A primer for clinicians. Reviews in Gastroenterological Disorders. 2(1): S12-S19.

Fletcher, R.H. 2002. Successful colorectal cancer screening starts with primary care. Reviews in Gastroenterological Disorders. 2(1): S27-S34.

Levin B et al. 2003. Emerging technologies in screening for colorectal cancer: CT colonographies, immunochemical fecal ooccult blood tests, and stool screening using molecular markers. CA Cancer J Clin. 53:44-55.

Ouyang DL, et al. 2005. Noninvasive testing for colorectal cancer: A review. Am J Gastroenterol. 100(6):1393-1403.

http://www.blackwell-synergy.com/doi/abs/10.1111/
j.1572-0241.2005.41427.x

Potter, J. 1999. Colorectal cancer: Molecules and populations. Journal of the National Cancer Institute 91(11):916-32.

How to Order Testing For Your Patient

Ordering screening for your patient through DNA Direct is easy.

1. Print and complete the DNA Direct Referral Form, and fax it to 806-993-6708, Attention: Clinical Services. (Make sure your patient signs the form and checks the box authorizing DNA Direct to release test results to you.


DNA Direct Referral Form

2. DNA Direct will send a Pregen-Plus collection kit directly to your patient and will coordinate all testing services. As part of the testing process, your patient is asked to create a user account with DNA Direct and answer a brief clinical questionnaire.
   
   
3. When testing is complete, as the referring physician you receive a copy of the test results and a Physician Letter, complete with test result interpretation, current medical guidelines, and scientific references. Your patient can then log on to their secure, password-protected account to learn more about their test results and receive updates on clinically relevant information.
   
   
4. You and your patients have ongoing access to support services from DNA Direct's board-certified genetics staff by phone (toll-free at 1-877-646-0222, M-F, 9-5 Pacific) and email (expert@dnadirect.com).