Conceitos Básicos
Multitarget stool DNA (mt-sDNA) test has a significantly higher detection rate for advanced serrated lesions compared to fecal immunochemical test (FIT) and fecal occult blood test (FOBT) in colorectal cancer screening.
Resumo
This study compared the real-world performance of three stool-based tests - multitarget stool DNA (mt-sDNA), fecal immunochemical test (FIT), and fecal occult blood test (FOBT) - for colorectal cancer (CRC) screening in average-risk individuals.
The key findings are:
There was no significant difference between the three stool-based tests in the detection of advanced neoplasia overall.
However, the mt-sDNA test showed a significantly higher detection rate for advanced serrated lesions compared to FIT and FOBT (11.3% vs 1.8% and 0%, respectively).
A sensitivity analysis evaluating outcomes specifically for advanced serrated lesions with hyperplastic polyps sized 5-9 mm also found that mt-sDNA had a higher detection rate than FIT and FOBT (17.7% vs 4.4% and 0%, respectively).
The positive predictive value for advanced neoplasia was the highest for the mt-sDNA test (30.7%), followed by FIT (22.8%) and FOBT (18.8%).
The authors concluded that while there was no significant difference between the stool-based tests in the detection of advanced neoplasia overall, the mt-sDNA test outperformed FIT and FOBT in detecting advanced serrated lesions, which are important precursors to colorectal cancer.
Estatísticas
The study included 302 individuals (mean age, 63 years; 59.27% women) who met the "average risk" criteria and had documented follow-up colonoscopy within 12 months of a positive stool-based test.
Citações
"Our study provided real-world evidence in a large, opportunistic screening program and showed that while there was no significant difference between SBTs [stool-based tests] in the detection of advanced neoplasia, more advanced serrated lesions were detected after positive mt-sDNA compared with other SBTs."