Multitarget Stool DNA Testing Has High Positive Predictive Value for Colorectal Neoplasia on the Second Round of Testing

Jordan K. Voss, Derek W. Ebner, Keli N. Burger, Douglas W. Mahoney, Mary E. Devens, Kari L. Lowrie, John B. Kisiel

Research output: Contribution to journalArticlepeer-review


Background & Aims: Multitarget stool DNA (mt-sDNA) testing is a stool-based screening test for colorectal cancer (CRC). In a single instance of testing, the pivotal Food and Drug Administration–approval study (NCT01397747) found that 16% of mt-sDNA tests were positive, and the positive predictive value (PPV) for CRC or advanced precursor lesions (APL) was 27.3%. We aimed to examine real-world longitudinal performance by determining the test-positive rate and PPV of mt-sDNA on the second round of testing. Methods: Colonoscopy and pathology reports were reviewed retrospectively for patients with a negative mt-sDNA on the first round of screening and a positive mt-sDNA on the second round. The test-positivity rate and PPV for CRC, APL, and any colorectal neoplasia were calculated for the second mt-sDNA and compared with baseline PPVs from a previously published cohort of patients from our institution who tested positive on the first round of screening. Results: A total of 2758 patients completed a second test at a median of 3.2 years after the first test. Of these, 422 (15%) had a positive second mt-sDNA. The PPV was 0.25% for CRC, 24% for APL, and 67% for any colorectal neoplasia. There was no significant difference in PPV on the second mt-sDNA test compared with the first round (24% vs 28% for APL; P =.12). Conclusions: mt-sDNA test positive rate and PPV were similar between the first and second rounds of screening. These observations confirm the utility of a second round of mt-sDNA screening and may inform estimates of mt-sDNA effectiveness for CRC screening.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
StateAccepted/In press - 2023


  • Colorectal Neoplasms/Prevention and Control
  • DNA Methylation
  • Early Detection of Cancer
  • Liquid Biopsy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


Dive into the research topics of 'Multitarget Stool DNA Testing Has High Positive Predictive Value for Colorectal Neoplasia on the Second Round of Testing'. Together they form a unique fingerprint.

Cite this