Multi-target stool DNA test bests FIT, colonoscopy in predicting colorectal neoplasia
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Multi-target stool DNA screening tests predicted neoplasia at follow-up colonoscopy more often than fecal immunochemical test or colonoscopy alone, according to a presentation at Digestive Disease Week.
“This study was undertaken to examine the real-world practice of stool-based tests, in terms of screening for colorectal cancer, and the yield on colonoscopy compared with people who just present with average risk for colonoscopy,” Joseph Anderson, MD, Dartmouth College Geisel School of Medicine, told Healio. “We used data from the New Hampshire Colonoscopy Registry; these data are useful because they’ve followed patients that have had colonoscopies over the past 20 years, so it provides real-world data on how these stool tests are being used in terms of what happens when patients present with positive results.”
Researchers identified 52,876 adult patients with an average risk for colorectal neoplasia to compare the yield of neoplasia identification among patients who underwent FIT preceded colonoscopy (n = 426; average age 65.3 years), mt-sDNA preceded colonoscopy (n = 240; average age 66.5 years) or colonoscopy alone (n = 52,210; average age 58.9 years). According to study results, patients who underwent mt-sDNA test had a higher yield at follow-up colonoscopy for any neoplasia compared with patients who underwent FIT or colonoscopy alone (67.1% vs. 43.9% and 37.5%, respectively); mt-sDNA also predicted serrated lesions more often than FIT. Further analysis demonstrated that positive FIT (OR = 1.34; 95% CI, 1.08-1.67) and positive mt-sDNA (OR = 3.72; 95% CI, 2.75-5.02) performed superiorly in predicting neoplasia compared with colonoscopy alone.
“When you look at patients who have positive stool-based tests, the yield of colorectal neoplasia or the precancerous polyps, which we want to detect and remove, is much higher in people who have had positive tests than people who just present for colonoscopy. In particular, the mt-sDNA test had a higher yield for these precursor lesions,” Anderson concluded. “The implication of this is that you could use these tests to potentially make colonoscopy more efficient, this is something for future investigation.”
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Anderson J, et al. Abstract 886. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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