Stool-Based Tests for Colorectal Cancer Screening: Performance Benchmarks Lead to High Expected Efficacy

Derek W. Ebner, John B. Kisiel

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Participation goals for colorectal cancer (CRC) screening in the USA have not been met. Non-invasive screening strategies may improve CRC screening participation. We highlight recent literature on stool-based screening performance and expectations for emerging non-invasive screening tests. Recent Findings: Stool-based CRC screening detects screen-relevant colorectal neoplasia and outperforms a currently available plasma assay. Though modestly sensitive for CRC, adherence to annual fecal immunochemical testing (FIT) is sub-optimal. Multi-target stool DNA (MT-sDNA) has greater adherence, superior sensitivity for screen-relevant lesions (including those in the proximal colon and sessile serrated architecture), and equivalent specificity to FIT over a 3-year period. Summary: Stool-based CRC screening tests are anticipated to reduce the incidence and mortality of CRC through detection of early-stage cancers and high-risk polyps. These endpoints in performance will need to be met by emerging blood sample–based tests in order have meaningful impact in clinical practice.

Original languageEnglish (US)
Article number32
JournalCurrent gastroenterology reports
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • Colonic neoplasms/prevention
  • Fecal immunochemical test
  • Liquid biopsy
  • Multi-target stool DNA test
  • Occult blood/methods

ASJC Scopus subject areas

  • Gastroenterology

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