Next-generation stool DNA test may improve sensitivity for colorectal cancer detection: NEJM

Colorectal cancer remains a leading cause of cancer-related mortality worldwide, highlighting the crucial need for effective screening strategies. A recent study unveiled the next-generation multitarget stool DNA test which is more effective in colorectal cancer screening. This innovative screening tool combines assessments of DNA molecular markers and hemoglobin levels to enhance specificity and accuracy in detecting colorectal cancer.

This research was conducted by Thomas Imperiale and colleagues on asymptomatic adults aged 40 and above who were undergoing screening colonoscopy and evaluated the performance of the new DNA test. The results revealed positive outcomes, with the test expressing a sensitivity of 93.9% for colorectal cancer and a specificity of 90.6% for advanced neoplasia, which includes colorectal cancer and advanced precancerous lesions.

Also, the next-generation DNA test demonstrated a sensitivity of 43.4% for advanced precancerous lesions by surpassing the performance of commercially available fecal immunochemical tests (FIT). While the FIT showed a sensitivity of 67.3% for colorectal cancer and 23.3% for advanced precancerous lesions, the new DNA test expressed superior performance in detecting both.

Despite the enhanced sensitivity, this next-generation DNA test showed a lower specificity for advanced neoplasia compared to FIT. However, no adverse events were reported during the study, underscoring the safety and feasibility of this innovative screening approach.

This study emphasized the significance of the outcomes in advancing colorectal cancer screening efforts. By highlighting the potential of next-generation DNA testing, there is improvement in early detection of colorectal cancer and precancerous lesions which ultimately saves lives through timely intervention.

Reference:

Imperiale, T. F., Porter, K., Zella, J., Gagrat, Z. D., Olson, M. C., Statz, S., Garces, J., Lavin, P. T., Aguilar, H., Brinberg, D., Berkelhammer, C., Kisiel, J. B., & Limburg, P. J. (2024). Next-Generation Multitarget Stool DNA Test for Colorectal Cancer Screening. In New England Journal of Medicine (Vol. 390, Issue 11, pp. 984–993). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2310336