Multitarget Stool DNA Test Has Higher Sensitivity for CRC Than FIT

THURSDAY, March 14, 2024 (HealthDay News) — A next-generation multitarget stool DNA test has higher sensitivity for colorectal cancer and advanced precancerous lesions than fecal immunochemical testing (FIT), according to a study published in the March 14 issue of the New England Journal of Medicine.

Thomas F. Imperiale, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues conducted a prospective study to examine a next-generation multitarget stool DNA test in asymptomatic adults aged 40 years or older who were undergoing screening colonoscopy. The sensitivity of the test for colorectal cancer and the specificity for advanced neoplasia were examined as the primary outcomes.

Of the 20,176 participants, 98; 2,144; 6,973; and 10,961 had colorectal cancer, advanced precancerous lesions, nonadvanced adenomas, and nonneoplastic findings or negative colonoscopy, respectively. The researchers found that the sensitivity for colorectal cancer was 93.9 percent and the specificity for advanced neoplasia was 90.6 percent with the next-generation test; sensitivity for advanced precancerous lesions was 43.4 percent and specificity was 92.7 percent for nonneoplastic findings or negative colonoscopy. With FIT, sensitivity was 67.3 and 23.3 percent for colorectal cancer and advanced precancerous lesions, respectively, and specificity was 94.8 and 95.7 percent for advanced neoplasia and nonneoplastic findings or negative colonoscopy, respectively. The next-generation test had superior sensitivity for colorectal cancer and advanced precancerous lesions compared with FIT, but lower specificity for advanced neoplasia.

“This new version of the test was more sensitive than a commercial FIT for all screening-relevant lesions, but the FIT had higher specificity,” the authors write.

The study was funded by Exact Sciences.

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