Using a multitarget stool DNA test helped improve the sensitivity for detecting precancerous colorectal lesions compared with fecal immunochemical tests alone in an average-risk population, according to study results.
Gerrit A. Meijer, MD, PhD, of the department of pathology at the Netherlands Cancer Institute, and colleagues wrote that early detection of colorectal cancer and precancerous lesions is critical, and the accuracy of screening tests is an important determining factor in the success of screening programs.
“Based on extensive cost-effectiveness evaluation, many organized screening programs use FIT as a triage test to select individuals for colonoscopy,” they wrote. “Although detection of blood in stool has shown to be successful in reducing mortality from CRC, sensitivity can still be improved.”
Researchers evaluated the efficacy of a multitarget stool DNA (MT-sDNA) test that evaluates for KRAS mutations and NDRG4 and BMP3 promoter methylation in addition to testing for hemoglobin. They collected 1,047 stool samples from patients with average-risk for CRC and subjected them to the MT-sDNA test.
They compared any results that detected CRC (n = 7), advanced precancerous lesions, including advanced adenomas and advanced serrated polyps (n = 119), and non-advanced adenomas (n = 191) with results from test that used only FIT.
Meijer and colleagues determined that the MT-sDNA test was more sensitive than FIT for the detection of precancerous lesions (46% vs. 27%; P < .001). While MT-sDNA detected 24 of 119 advanced lesions that were not detected by FIT, FIT detected just one precancerous lesion that was missed by MT-sDNA. The specificity for the MT-sDNA and FIT among individuals with nonadvanced or negative findings were 89% and 93%, respectively.
The two tests had similar sensitivity for detecting individuals with high-risk advanced adenomas from individuals with low-risk adenomas.
“The MT-sDNA test combining DNA methylation and mutation markers with hemoglobin has a significantly increased sensitivity for advanced precancerous lesions than FIT alone at equal specificity, indicating its potential for application in population screening for CRC,” Meijer and colleagues concluded. – by Alex Young
Disclosures: Meijer reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.