TY - JOUR
T1 - Stool-Based Tests for Colorectal Cancer Screening
T2 - Performance Benchmarks Lead to High Expected Efficacy
AU - Ebner, Derek W.
AU - Kisiel, John B.
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - Colonic neoplasms/prevention
KW - Fecal immunochemical test
KW - Liquid biopsy
KW - Multi-target stool DNA test
KW - Occult blood/methods
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U2 - 10.1007/s11894-020-00770-6
DO - 10.1007/s11894-020-00770-6
M3 - Review article
C2 - 32494878
AN - SCOPUS:85086002515
SN - 1522-8037
VL - 22
JO - Current gastroenterology reports
JF - Current gastroenterology reports
IS - 7
M1 - 32
ER -