Diagnostic Performance of Stool-based Testing for Colorectal Lesions Among Average-risk Individuals: A Real-world Evidence Study

Catherine Cheney; Alice Parish; Donna Niedzwiecki; Chukwuemeka Oko; Christy Walters; Brian A Sullivan

doi:10.1097/MCG.0000000000002053

Diagnostic Performance of Stool-based Testing for Colorectal Lesions Among Average-risk Individuals: A Real-world Evidence Study

J Clin Gastroenterol. 2024 Aug 1. doi: 10.1097/MCG.0000000000002053. Online ahead of print.

Authors

Catherine Cheney¹, Alice Parish², Donna Niedzwiecki², Chukwuemeka Oko¹, Christy Walters¹, Brian A Sullivan¹

Affiliations

¹ Department of Medicine, Duke University Medical Center.
² Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, NC.

PMID: 39083510
DOI: 10.1097/MCG.0000000000002053

Abstract

Objective: We assessed the real-world performance of stool-based tests (SBTs) for colorectal cancer screening.

Materials and methods: Retrospective review of average-risk individuals with positive SBT for advanced neoplasia (adenocarcinoma, advanced adenoma, and/or advanced serrated lesions) detection at follow-up colonoscopy.

Results: There was no statistical difference in the detection of advanced neoplasia (P= 0.16) between SBTs [30.7% for multitargeted stool DNA (mt-sDNA) vs 22.8% for fecal immunochemical test]. However, there was a significant difference in the detection of advanced serrated lesions (11.3% for mt-sDNA vs 1.8% for fecal immunochemical test, P< 0.001).

Conclusion: There was no difference between SBTs for advanced neoplasia detection, though mt-sDNA detected significantly more advanced serrated lesions.